PS497 Unit 6 Continuing Care Program Design Paper Example

Green, Yellow, Red on Monday Morning: A PS497 Unit 6 Program Design Paper

[Student Name]

Purdue University Global

PS497: Bachelor's Capstone in Addiction

Unit 6 Program Design Paper

[Instructor Name]

[Date]

The writer, the program, the staff, the clients and every figure are composite and illustrative; the articles cited are real.

Purpose

Clients at our Boise outpatient program often relapse in the weeks after intensive treatment ends, as Wes did three weeks after graduating. The program's purpose is to extend lighter, active contact for six months after intensive outpatient treatment, so that the transition out of structured care does not become a drop-off. McKay (2009) found that longer continuing care and active outreach were associated with better outcomes, and the design aims to deliver both at a cost a community program can carry.

Eligibility

All adults completing our intensive outpatient program are eligible, regardless of substance. Participation is voluntary and does not affect access to other services. Clients without a smartphone or data plan receive a loaner phone; those who prefer not to use an app can check in by plain text message.

Components

The program has four parts. A weekly check-in through a secure platform asks five ratings, craving, mood, sleep, pain and days of use, and one open question. Counselors provide text support during set hours, with an active message to each client on a day the client identifies as high risk. A monthly evening group reviews skills and allows graduates to support each other. And medication management continues with the client's physician where relevant.

Gustafson et al. (2014) found benefits from a smartphone system that supplemented usual care after residential treatment, and the design follows that model: the phone adds contact; it does not replace counselors or groups.

The Monday Workflow

Each Monday morning, the platform sorts the previous evening's check-ins into three groups using rules the clinical director approved. Green means low craving, no use and no concerning comments; the counselor sends a brief acknowledgment. Yellow means rising craving, poor sleep, a missed check-in or one day of use; the counselor sends a personal message and offers a call. Red means several days of use, a comment suggesting crisis or two missed check-ins; the counselor calls that day and involves the clinical team if needed.

The traffic-light sort lets two counselors read thirty check-ins and know in minutes whom to call first.

What Counselors Changed

I presented a draft to the counseling team before finalizing it. Their concerns reshaped it. The first draft asked counselors to reply to every check-in within two hours on Sunday evenings; they pointed out that no one is scheduled on Sunday nights and that a promise of immediate response would be broken. The design now promises a reply within one business day and tells clients plainly that no one monitors the app around the clock. They also asked that red alerts go to a shared queue rather than one counselor's phone, so that vacations and sick days do not leave clients unanswered.

A Week in the Program for One Client

Following one client through a week shows how the parts fit. On Sunday evening, Wes opens the app and rates his craving at six out of ten, his sleep at four, his back pain at seven and his drinking days at zero, and writes, "Long week, son mad at me." On Monday morning, the platform sorts his check-in as yellow, because craving and pain rose from the week before. His counselor sends a personal message by ten, asking whether Thursday still feels like the hardest night and offering a call. Wes replies that he would rather text. On Thursday afternoon, the counselor's planned message arrives as he finishes his route: a reminder of his three coping steps and the name of his brother-in-law. That evening Wes texts that he went to the workbench instead of the store. On Saturday, his wife sees his ratings, as he agreed, and asks him about his son. The next Sunday, his craving rating is four. None of these contacts takes more than a few minutes of staff time, but together they reach him at the moments his formulation identified as dangerous.

Measuring What Matters During the Pilot

Even before the formal evaluation, the program will track a few numbers each week: the share of check-ins completed, the number of yellow and red alerts, the time taken to respond, and how many clients attend the monthly group. Engagement is the first thing that can fail, and these numbers will show it early.

Staffing and Training

Two counselors will each devote about a quarter of their time to the program during the pilot. Training covers the platform, the triage rules, writing brief supportive messages, documentation, crisis procedures and privacy rules. A supervisor reviews a sample of messages monthly and meets with both counselors to discuss difficult exchanges.

Remote Care and Access

Lin et al. (2019) found that telemedicine-delivered substance use treatment generally produced outcomes similar to in-person care and could improve access, particularly for rural patients. About a third of our clients live outside Boise, some more than an hour away, and the monthly group will offer a video option for them.

Costs

The pilot budget covers the platform license for twenty users, ten refurbished phones with six months of data, counselor time already budgeted within existing positions, and evening group facilitation. A small state grant covers the phones and platform. If the pilot succeeds, costs per client fall as enrollment grows, because the platform license is priced in blocks and the group can absorb more members without more staff. The clinical director has asked for a cost comparison with the program's current continuing care, which consists mostly of unanswered reminder calls, so that the board can see what the added contact buys.

The Pilot

The pilot will enroll the first twenty consenting graduates over three months and follow each for six months. Before launch, the privacy officer will review the platform contract, and the consent form will be tested with three former clients for clarity, and revised until each can explain it back in their own words. The evaluation plan, in a later paper, sets the measures and decision rules.

Conclusion

The program extends active contact for six months after intensive treatment through weekly check-ins, counselor text support, a monthly group and continued medication. The design rests on McKay's case for longer, active contact, on Gustafson and colleagues' evidence for a phone added to care, and on Lin and colleagues' support for remote options. Counselors' concerns produced a workflow that two part-time staff can actually run.

References

Gustafson, D. H., McTavish, F. M., Chih, M.-Y., Atwood, A. K., Johnson, R. A., Boyle, M. G., Levy, M. S., Driscoll, H., Chisholm, S. M., Dillenburg, L., Isham, A., & Shah, D. (2014). A smartphone application to support recovery from alcoholism: A randomized clinical trial. JAMA Psychiatry, 71(5), 566-572. https://doi.org/10.1001/jamapsychiatry.2013.4642

Lin, L. A., Casteel, D., Shigekawa, E., Weyrich, M. S., Roby, D. H., & McMenamin, S. B. (2019). Telemedicine-delivered treatment interventions for substance use disorders: A systematic review. Journal of Substance Abuse Treatment, 101, 38-49. https://doi.org/10.1016/j.jsat.2019.03.007

McKay, J. R. (2009). Continuing care research: What we have learned and where we are going. Journal of Substance Abuse Treatment, 36(2), 131-145. https://doi.org/10.1016/j.jsat.2008.10.004