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Indian Health Service The Federal Health Program for American Indians and Alaska Natives


     Indian Health Manual
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Part 3, Chapter 18:  Manual Attachment I

Glossary of Terms


AA, Alanon, Alateen, Alatot:  World-wide fellowship groups that have evolved since the founding of Alcoholics Anonymous in 1935 for the maintenance of sobriety and happy life-styles without the influence of alcohol.

Affiliation:  A relationship established by the governing authorities of two organizations and signified by an annual written agreement.  The terms specify services, space and/or personnel provided to one organization by the other for the accomplishment of mutually supported service goals.

Aftercare Services:  Care provided to clients who have progressed through stages of development; e.g., emergency, inpatient, intermediate and/or outpatient services, to the point in recovery where benefits from a plan of continued community-based services will increase and maintain the gains made to date in the treatment process.  For those being discharged from primary residential treatment programs, aftercare is required and includes all services provided after discharge form PRT.

Alcohol Intoxication:  Criteria for alcohol intoxication include:

  1. Recent investigation of alcohol (with no evidence suggesting that the amount was insufficient to cause intoxication in most people).

  2. Maladaptive behavioral effects; e.g., fighting, impaired judgment, interference with social or occupational functioning.

  3. At least on of the following physiological signs:

    1. slurred speech

    2. incoordination

    3. unsteady gait

    4. nystagmus

    5. flushed face

  4. At least on of the following psychological signs:

    1. mood change

    2. irritability

    3. loquacity

    4. impaired attention

  5. Conditions not due to any other physical or mental disorder (DSM III, September 1980, p. 131).

  6. Blood alcohol level of .10 or greater (legal definition may be less in some states).

Alcoholism:  A state, psychological and/or physical resulting from taking alcohol, characterized by behavioral and other responses that always include a compulsion to take alcohol on a continuous or periodic basis in order to experience its psychological effects, and sometimes to avoid the discomfort of its absence; tolerance may or may not be present.  (Referred to as "Alcohol Dependency Syndrome" in the International Classification of Diseases, WHO, 1977).

Alcoholism/Substance Abuse Program:  Any service program comprised of any of one or more designated program components which may be affiliated, internally and/or externally contractually related, and drawn from one or more organizations responsible for providing continuity of service to, and care of, people with problems associated with the use of alcohol and/or other drugs.

Alcohol Treatment Guidance System:  A data system developed by IHS to guide and monitor the provision of services to clients/patients receiving treatment from IHS contract and direct care programs.

Area Intervention Team:  The Team is under the supervision of the Area Alcoholism/Substance Abuse Coordinator.  Consists of a minimum of two qualified Area level staff members with expertise in the field of alcoholism and substance abuse prevention and treatment.

Assessment:  That act or result of judging the worth or value of something or someone.  This term in synonymous with evaluate.

Client:  A person who receives treatment services.  The term is synonymous with "patient" or "resident".

Co-Alcoholic:  A person, generally the spouse of the alcoholic, who contributes at least implicitly through emotional support toward maintenance and continuation of the primary alcoholic's dependency.  This is a condition requiring counseling.

Community Education:  The use of information, media resources, and skills development groups to increase awareness in community members and employees of institutions; i.e., tribal groups, courts, religious organizations, social agencies, and schools.  Problems of alcoholism/substance abuse, the availability of prevention and treatment resources, and techniques for motivating an individual into treatment are stressed.

Community Rehabilitation/Aftercare:  The process of providing nonresidential diagnostic and follow-up treatment services for individuals who require therapeutic and supportive counseling and referral services while living independently.

Consultation:  The act of providing information and/or technical assistance to a particular group or individual seeking resolution of a specific problem(s).

Counselor:  An individual who provides professional or non-degreed professional therapeutic intervention services or personal guidance.

Detoxification:  Care provided while the person is in withdrawal from alcohol or other drugs.

Diagnosis:  Evaluation of a person through a multi-disciplinary staffing process using procedures and/or criteria to determine the nature and extent of a disease.  Observations provide a basis for planning a treatment program for the client.

Documentation:  Provision of written, dated, and authenticated evidence to substantiate compliance with standards; e.g., minutes of meeting, memoranda, schedules, notices, announcements, progress notes, treatment plans, ATSG, etc.

Drop-In Center:  A 40 hour per week, non-medical, non-residential facility, where individuals under the influence of alcohol and at risk of physical or emotional damage as a result of intoxication, admit themselves for the purpose of receiving nourishment, temporary shelter and first aid.  In addition, the agency provides motivational counseling, information and referral for detoxification, treatment alternatives, or other needed community services.  A Drop-In Center may also serve individuals who are considered at high risk of becoming alcoholism/substance abusers, by providing special emphasis on education and recreational activities as a diversion from substance abuse activities.

Emergency Care:  A network of services that provides all persons experiencing acute problems related to alcohol use and abuse immediate diagnosis and care, as well as appropriate referral for continuing care after emergency treatment.

Follow-up:  A required monitoring service by the agency designed to assure continued successful adaptation to living through periodic contact with individuals who have been in one or more phases of treatment and are now living independently and practicing adaptive skills for living.  As problems are identified, referrals are made to appropriate supportive services.

Halfway House:  A non-medical, residential facility where individuals who have been detoxified and require a moderately structured non-permanent living arrangement are admitted.  Individuals practice improved living skills acquired in primary residential care or earlier life experiences while receiving feedback and emotional support from fellow residents and alcoholism treatment specialists.

Incident Report:  Documentation of an event that is likely to lead to adverse effects and/or that varies from established policies and procedures pertaining to patient care.

Inpatient:  A patient who receives food and lodging and supervised acre for a period of at least 24 hours.  Patients meet appropriate criteria for the various inpatient components.

Medical Services:  Services performed at the direction of a physician or by physicians, nurses and other professional and technical personnel.  (See Medical Care).

Intake:  The administrative and assessment process for admission to a program.

Multi-Disciplinary Team:  A group of clinical staff members composed of representatives from different professions, disciplines, or service areas.

Non-Degreed Professional:  A person who through experience and/or study has attained a degree/certificate of expertise in one or more of the areas related to the use of alcohol.

Outpatient:  A service delivery program which provides individual, group and/or family treatment counseling as primary modes of intervention to the alcoholism/substance abuse client.  Other forms of direct assistance may be utilized as supportive therapy, e.g., consultation and referral.

Outreach:  A service designed to reach into the community and identify individuals and/or families presently in need of intervention and treatment.  Intervention in the early stages of involvement is stressed, information about community resources is provided and entry into treatment is facilitated through motivational counseling, referral and transportation.

Patient:  A person who receives treatment services.  The term is synonymous with "client" or "resident".

Prevention:  Activities designed for health promotion/disease prevention or measures undertaken to avoid the onset of a predetermined disease or to reduce risk factors.  Includes primary prevention, which is group oriented and is primarily educational in nature, and secondary prevention or intervention which includes activities to detect and intervene in alcoholism/substance abuse in the early stages.  The term is applicable to any strategy that intentionally or unintentionally reduces the incidence of any disorder.

Primary Prevention:  Encompasses activities directed toward specifically identified vulnerable high risk groups (children of alcoholic/substance abuse parents, students enrolled in schools with high rates of substance abuse, etc.) for whom measures can be taken to avoid the onset of a predetermined disorder.

Primary prevention efforts are directed toward promotive or proactive interventions focusing not on the alleviation of pathology per se, but on the development of positive, adaptive, and adjustive capacities and skills.  Programs for the promotion and/or disease prevention fall within the domain of primary prevention and are primarily educational rather than clinical in conception and operation; their ultimate goal is to increase people's capacities for dealing with vulnerable situations and for taking steps to improve their own lives.

Primary Residential Treatment:  A 24-hour, non medical, residential treatment facility where individuals who have been detoxified and require a closely supervised and sheltered living arrangement are admitted for intensive treatment of problems associated with drinking and other drug use.  Individualized plans for treatment are negotiated and implemented to facilitate the development of new life skills and abstention from drinking and other self-destructive behaviors.

Progress Notes:  Written entries into a client's chart about movement of the client toward defined goals made by the primary counselor or other staff persons including information such as date and time, status of the client at the last observation, behavior, attitude or change observed, action(s) taken by the counselor, and the counselor's signature and title.

Quality Assurance:  A process of review and monitoring of services rendered to clients/patients of alcoholism/substance abuse programs directed toward 1) the structure within which care is given; 2) the process of providing the care; and 3) the outcome of the care given.

Quality implies having the characteristics of excellence.  The term assurance implies having a commitment beyond the measurement or evaluation of quality to undertake actions that will result in the correction of deficiencies and finding ways to improve care.  A quality assurance program, therefore, follows the following five steps:

  1. Criteria development

  2. Description of the actual practice

  3. Judgment or evaluation (does #2 = #1)

  4. Corrective action (if #2 does not = #1)

  5. Reassessment of #4 (does #2 now = #1)

Recreation Technician:  Assists the recreation therapist in supervising individual and group activities, and applies individual plans worked out by the recreation therapist.

Recreation Therapist:  Has a degree in recreation therapy and can perform individualized client assessments, develop individual treatment plans in decision-making, arts, crafts, games, and activities.

Rehabilitation:  The process by which a client achieves self-reliance and mastery to become productive through personal and skill redevelopment activities.

Secondary Prevention:  Focuses on the early detection and the reduction of the severity of the disorder.  Secondary efforts are directed toward individuals and are instituted only after some initial manifestation or disorder is identified.

Tertiary Prevention (Acute Care/Rehabilitation):  Interventions occur once a disorder manifests clinically diagnosable signs and symptoms are, by definition, oriented toward treatment and rehabilitation.  The goals of such activities are to minimize, insofar as possible, long-term after-effects and the recurrence of the disorder.



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