What medications are FDA approved for addiction?
In addition to psychological interventions, these should include accessibility to FDA approved medications for addiction (e.g., buprenorphine/naloxone, methadone, naltrexone/depot naltrexone, acomprosate) as well as psychotropic medication for other types of psychiatric conditions (e.g., SSRIs etc.). This is typically combined with qualified staff ...
Why should addiction treatment programs collect vital signs?
Similar to regular assessment of blood pressure at each check-up in treating hypertension, addiction treatment programs should collect “addiction and mental health vital signs” in order to monitor the effectiveness or ineffectiveness of the individualized treatment plan and adjust it accordingly when needed .
How does dropout affect retention?
Dropout leads to worse outcomes, so it is vital to employ strategies to enhance engagement and retention. These include creating an atmosphere of mutual trust through clear communication and transparency of program rules, regulations, and expectations.
How does treatment program work?
Treatment programs can also work to retain patients by providing client-centered, empathic, counseling that works to build strong patient-provider relationships. They also can use motivational incentives to reward patients for continued attendance and abstinence. 7.
What are the co-occurring disorders in psychiatric treatment?
As discussed above, patients in treatment may have co-occurring psychiatric disorders, like depression and anxiety, as well as other medical problems like hepatitis C, alcoholic liver disease, or sexually transmitted diseases. Programs should incorporate comprehensive approaches that directly address these additional concerns, or otherwise assertively link patients to needed services. Treating the whole patient, will improve the likelihood of substance use disorder recovery and remission.
Introduction
Orthodontic finishing is characterized as an art made up of individual perceptions and minute details. It is described as the final stage of fixed orthodontic mechanotherapy, during which fine detailing takes place to idealize individual positions of the tooth.
General considerations in Finishing and Detailing
Rebecca Poling 2 described a comprehensive detailed method of evaluating the orthodontic patient in the finishing stage of treatment. She also described a system of written notations to guide the orthodontist to achieve excellent finishing.
Finishing in Roth prescription
Roth 12, 13 altered the prescription of the Andrews bracket in all three planes of space to achieve over corrections of the teeth prior to appliance removal. He also added the goals of gnathologic finishing as part of orthodontic treatment.
Finishing in MBT prescription
The MBT prescription 14 was officially introduced in 1997 by McLaughlin, Bennett and Trevisi after reviewing Andrew’s original findings and additional research from Japan. The finishing stage in MBT takes into account horizontal, vertical, transverse, dynamic, cephalometric and esthetic considerations.
Finishing in Lingual Orthodontics
The finishing phase is the most challenging and difficult stage in Lingual Orthodontics. In certain cases, finishing of a case will take as much time or longer than the correction of the major problems of malocclusion, therefore, the time spent on finishing plays a major role in determining the overall treatment duration.
Tooth positioner in case finishing
The tooth positioner, which was introduced by Kesling 19 in 1945, is a one-piece, resilient appliance which may be used for finishing orthodontic cases. This appliance occupies freeway space, covers the clinical crowns of all the teeth and about 3 mm of the buccal and lingual gingival mucosa.
Special finishing procedures to avoid relapse
Changes resulting from continued growth in a Class II, Class III, deep bite or open bite pattern contribute to a return of the original malocclusion. Controlling this type of relapse requires a continuation of active treatment after the fixed appliances have been removed, rather than specific finishing procedures to prevent relapse.
Assessment and Treatment Matching
Comprehensive, Integrated Treatment Approach
- As discussed above, patients in treatment may have co-occurring psychiatric disorders, like depression and anxiety, as well as other medical problems like hepatitis C, alcoholic liver disease, or sexually transmitted diseases. Programs should incorporate comprehensive approaches that directly address these additional concerns, or otherwise assertively link patients to needed servi…
A Dignified, Respectful, Environment
- The treatment program should possess at least the same type of quality environment as one might see in other medical environments (e.g., oncology or diabetes care). You don’t need palm trees and luxury mattresses, but you should expect a clean, bright, cheerful, and comfortable facility. It is important that the program treats substance use disorde...
Significant Other and/or Family Involvement in Treatment
- Engaging significant others and loved onesin treatment increases the likelihood that the patient will stay in treatment and that treatment gains will be sustained after treatment has ended. Techniques to clarify family roles, reframe behavior, teach management skills, encourage monitoring and boundary setting, re-intervention plans, and help them access community servic…
Employ Strategies to Help Engage and Retain Patients in Treatment
- Dropout from addiction within the first month of care is around 50% nationally. Dropout leads to worse outcomes, so it is vital to employ strategies to enhance engagement and retention. These include creating an atmosphere of mutual trust through clear communication and transparency of program rules, regulations, and expectations. Treatment programs can also work to retain patie…
Use of Evidence-Based and Evidence-Informed Practices
- Programs that deliver services founded on scientific research and principles and that are delivering the available “best practices” tend to have better outcomes. In addition to psychological interventions, these should include accessibility to FDA approved medications for addiction(e.g., buprenorphine/naloxone, methadone, naltrexone/depot naltrexone, acomprosate) as well as psy…
Qualified Staff, Ongoing Training, and Adequate Staff Supervision
- Having multi-disciplinary staff (e.g., addiction, medicine, psychiatry, spirituality) can help patients uncover and address a broad array of needs that can aid addiction recovery and improve functioning and psychological wellbeing. Staff with graduate degrees, and adequate licensing or board certification in these specialty areas are indicators of higher quality programs. In addition…
Measurement of Program Performance Including During-Treatment “Outcomes”
- A further indicator of quality treatment is having reliable, valid measurement systems in place to track patients’ response to treatment. Similar to regular assessment of blood pressure at each check-up in treating hypertension, addiction treatment programs should collect “addiction and mental health vital signs” in order to monitor the effectiveness or ineffectiveness of the individu…
External Accreditation from Nationally Recognized Quality Monitoring Agencies
- Accreditation from external regulatory organizations such as the Joint Commission on Accreditation of Healthcare organizations (JCAHO; aka “the Joint Commission”), the Commission on Accreditation of Rehabilitation Facilities (CARF), and the Council on Accreditation (COA); and other programs licensed by the state are required to offer minimum levels of evidence-based car…