Per COMAR 10.47.02.03, WIN’s Early Intervention Program (EIP) is a prevention program that treats youth and adults who are, for a known reason, at risk for developing alcohol or substance use disorder but for whom there is not yet sufficient information to validate an alcohol or drug dependence. This six-week program provides basic education for individuals who require interventions that address alcohol and/or substance abuse.
Eligibility – Youth and adult clients appropriate for this level of treatment shall meet the current edition of the ASAM Placement Criteria for Level 0.5, or its equivalent as approved by the Administration. Per COMAR 10.47.01.04H(1-4), WIN Team provides Early Intervention services to youth via treatment protocols that provide for the needs of children and adolescents and incorporates the use of promising family intervention practices. The documented consent of a parent or guardian is secured for all children and adolescents interested in admission to the program. The Addiction Specialist, in collaboration with the Clinical Director, will ensure that the appropriate level of services and individualized interventions are documented in the treatment plan for the youth client. The WIN Team will not admit children and adolescents into the Early Intervention program when elements of the program make treatment, care, and rehabilitation for youth contraindicated.
The educational needs of youth admitted to the program will be met in compliance with local, State, and Federal laws and regulations by competent staff who meet relevant background screening requirements.
Youth eligible for this level of service will meet the following criteria for the six major life areas detailed in ASAM:
- Acute Intoxication and/or Withdrawal Potential – No withdrawal risk
- Biomedical Conditions/Complications – None or stable
- Emotional/Behavioral/Cognitive Conditions and Complications – None or very stable
- Readiness to Change – Willing to explore how use affects personal goals
- Relapse/Continued Use/Continued Problem Potential – Needs understanding or skills to change current use or high-risk behavior
- Recovery Environment – Environment includes people with high-risk behaviors
Adults eligible for this level of service will meet the following criteria for the six major life areas detailed in the ASAM:
- Acute Intoxication and/or Withdrawal Potential – No withdrawal risk
- Biomedical Conditions/Complications – None or stable
- Emotional/Behavioral/Cognitive Conditions and Complications – None or very stable
- Readiness to Change – Willing to explore how use affects personal goals
- Relapse/Continued Use/Continued Problem Potential – Needs understanding or skills to change current use or high-risk behavior
- Recovery Environment – Environment increases risk of use
Screening and Assessment – The ASAM Addiction Severity Index is used as the standardized screening assessment for newly enrolled clients. A problem-oriented screening instrument is used to further assess the treatment needs of youth clients. WIN Addiction Specialist, in collaboration with the prospective client and/or guardian as applicable, completes a comprehensive assessment for each eligible participant within 2 weeks of program admission that addresses the following areas:
- Physical Health
- Employment or Financial Support
- Drug and Alcohol Abuse
- Treatment History
- Legal History
- Family and Social Dynamics
- Academic Needs
- Mental Health
The assessment results in a recommendation for the eligible participant to be enrolled in the Early Intervention program and may also identify a need for a referral to a treatment program.
Treatment Planning – The initial comprehensive assessment informs the content of the treatment plan that is developed within 7 working days in collaboration with the enrolled client, his or her parent or guardian as applicable, and the Addiction Specialist. The treatment plan reflects the individualized needs of the client, inclusive of: socialization, alcohol and drug abuse or dependence, psychological, vocational, educational, physical health, legal interventions, and family dynamics. The individualized interventions noted in the treatment plan reflect the following:
- Long-range and short-range treatment plan goals and objectives
- Strategy for implementation of treatment goals and objectives
- Target completion date for treatment goals and objectives
- A schedule of individual, group, and if appropriate family counseling services
- Criteria for successful completion of treatment
- Referrals to ancillary services and/or self-help groups, as needed
In the rare instance that the Addiction Specialist is unable to develop a treatment plan within 7 working days of the completed comprehensive assessment, the Clinical Director will determine and document the reason for the delay in the client’s medical record, and assign another Addiction Specialist to develop the treatment plan within 7 working days of the Clinical Director’s documentation of the delay.
Individualized Service Interventions – The treatment services and interventions available to youth and adult clients admitted to the Early Intervention program include: alcohol and drug education; individual, family, and/or group counseling; and referral services.
- Alcohol, drug, and infectious disease education – Within the first 30 days of treatment, the Addiction Specialist will provide and document in the client’s medical record evidence that the client has completed training in infectious disease education. The infectious disease education includes information dissemination regarding human immunodeficiency virus, hepatitis, sexually transmitted diseases, and tuberculosis. Ongoing alcohol and drug education is available to clients via scheduled individual or group counseling sessions. The alcohol, drug, and infectious disease education series culminates with a client risk assessment, identification of risk reduction interventions, and, if appropriate, referral for counseling and testing.
- Individual and group counseling – Individual counseling is an integral part of the Early Intervention program. Sessions are initially devoted to the review of treatment plan goals and expectations, scheduled with clients at least twice monthly, and available upon request and/or a clinical determination. Subsequent individual counseling sessions focus on the completion of a First Step Workbook published by Narcotics Anonymous, the development of relapse prevention plans, and addressing personal issues that arise during the course of treatment. A 12-hour group counseling service is mandated by the State of Maryland for those convicted of driving while intoxicated or while under the influence of illegal substances while on State roads. Group counseling is optional for all other enrolled Early Intervention program participants. Group counseling is recovery-focused, educational, is not limited in size, and follows a best practice curriculum that covers the basic concepts of alcoholism and addiction, signs and symptoms of dependency, and the medical, emotional, and spiritual effects of alcohol and/or substance abuse. Enrolled clients attend group counseling sessions weekly and may choose to attend a day or evening group session. Addiction Specialists record in the client’s medical record an individualized progress note after each counseling session that is available to the client, parent and/or guardian as applicable, and any other service provider the client has consented to having access to his or her program attendance and treatment progress
- Family Counseling – WIN offers monthly family counseling, education, and support services when deemed a clinically appropriate intervention for enrolled clients. A comprehensive Family Needs and Recovery Environment assessment of the treatment needs of the family members of an enrolled client is completed prior to assigning an Addiction Specialist to the family and determining a family counseling session schedule. Outcomes of the assessment are noted in the client’s treatment plan with specific indication of family member involvement in the client’s recovery process. Family counseling sessions are purposed to educate family members on the basic concepts of alcoholism and drug abuse; its signs and symptoms; its medical, emotional, and spiritual effects; and effective relapse prevention and coping strategies. When appropriate, family members are also referred to other human service providers that address intense family counseling and/or case management needs. The family members of all enrolled clients, whether or not the family counseling service is utilized, receive verbal and written information about free and low- cost self-help family groups and supported activities located within their community.
- Referral Services – WIN maintains a listing of agency referral agreements and local providers that offer mental health services, social services, and substance abuse treatment services. The WIN Team’s continuum of mental and social services are available to enrolled clients and their family members, provided the appropriate eligibility requirements are
Service Continuity, Change, and/or Discharge – The enrolled client’s level of addiction severity and response to substance abuse treatment determines his or her length of stay in the Early Intervention program. Treatment plan goals are collaboratively developed with the client and are primarily used to determine the length of treatment, as opposed to a preset structure for the individual. Generally, services are continued for enrolled clients when it is evident that he or she is making progress toward goal achievement and it is reasonable to expect continued progress with the existing treatment.
There are many reasons an Addiction Specialist, in consultation with a Clinical Director, may recommend that a client be transferred to a different type of services. The two most common reasons are: 1.) The client is not able to achieve the current goals of their treatment but could achieve similar goals with a different treatment modality; 2.) The client has achieved his or her original treatment goals but has since developed new treatment challenges that are best addressed in a different treatment setting. When a youth or adult client is identified for a service change or transfer, the client’s discharging Addiction Specialist, in consultation with the Clinical Director, shall complete a written transfer summary at the time of the service transfer that includes: the reason for admission and discharge, the client’s address and contact phone number, current medications (if applicable), and the diagnosis and prognosis of the client at the time of service transfer.
Early Intervention Program recipients will be discharged from services when there is no court-ordered mandate that prevents compliance with a discharge request, the client has asked to be discharged, and/or the client has fulfilled the goals of the treatment plan and no other service is needed to maintain sobriety and/or abstinence. When a youth or adult client is identified for discharge, the Addiction Specialist, in consultation with the Clinical Director, shall complete a written discharge summary within 30 days of the client’s discharge from the program that includes: the reason for admission and discharge; the client’s address and contact phone number; current medications (if applicable); the diagnosis and prognosis of the client at the time of service discharge; a summary of the services delivered to the client inclusive of the frequency, duration, and impact of services rendered; continuing service recommendations; summary of the transition progress; and the extent of the client’s involvement in the discharge plan.
Service Continuity, Change, and/or Discharge – The enrolled client’s level of addiction severity and response to substance abuse treatment determines his or her length of stay in the Early Intervention program. Treatment plan goals are collaboratively developed with the client and are primarily used to determine the length of treatment, as opposed to a preset structure for the individual. Generally, services are continued for enrolled clients when it is evident that he or she is making progress toward goal achievement and it is reasonable to expect continued progress with the existing treatment. There are many reasons an Addiction Specialist, in consultation with a Clinical Director, may recommend that a client be transferred to a different type of services. The two most common reasons are: 1.) The client is not able to achieve the current goals of their treatment but could achieve similar goals with a different treatment modality; 2.) The client has achieve his or her original treatment goals but has since developed new treatment challenges that are best addressed in a different treatment setting.
When a youth or adult client is identified for a service change or transfer, the client’s discharging Addiction Specialist, in consultation with the Clinical Director, shall complete a written transfer summary at the time of the service transfer that includes: the reason for admission and discharge, the client’s address and contact phone number, current medications (if applicable), and the diagnosis and prognosis of the client at the time of service transfer.
Early Intervention Program recipients will be discharged from services when there is no court-ordered mandate that prevents compliance with a discharge request, the client has asked to be discharged, and/or the client has fulfilled the goals of the treatment plan and no other service is needed to maintain sobriety and/or abstinence. When a youth or adult client is identified for discharge, the Addiction Specialist, in consultation with the Clinical Director, shall complete a written discharge summary within 30 days of the client’s discharge from the program that includes: the reason for admission and discharge; the client’s address and contact phone number; current medications (if applicable); the diagnosis and prognosis of the client at the time of service discharge; a summary of the services delivered to the client inclusive of the frequency, duration, and impact of services rendered; continuing service recommendations; summary of the transition progress; and the extent of the client’s involvement in the discharge plan.
