Maple Grove/Chaska Patient Handbook 2023 - 53

information from family and others. When a risk has been identified, the
concerns are communicated to all members of the treatment team and
evaluated for potential supportive strategies to be implemented through the
treatment planning process. Measures used to mitigate and respond to this
increased risk include the following:
* Training of all workforce in non-violent crisis intervention techniques.
* Use of the therapeutic environment to model and coach healthy responses
to anger and aggression by others.
* Use of swift and supportive intervention with clients who display
aggressive behavior.
* Facilitation of positive conflict resolution meetings when client to
workforce or client to client conflicts are identified.
* Individual and group therapy is offered to those clients for whom trauma
secondary to abuse history is an identified issue.
* Family therapy sessions may be recommended and/or provided by the
program for clients and their families when clinically indicated, either
during treatment or as a component of continuing care.
* Communication of facility rules prohibiting physical aggression to include
violence, excessive horseplay and appropriate physical boundaries.
* Proactive treatment planning for clients with a known history of
aggression or violence to avert atypical discharge.
* Use of behavioral agreements in response to concerns arising during
treatment.
* When a patient displays aggression in the facility, evaluation of
appropriateness for continued stay is completed by the multidisciplinary
team. If the client is discharged for safety reasons, appropriate referrals are
arranged. In extreme circumstances, law enforcement may be involved.
If the client is to remain in treatment, additional protective measures are
implemented as appropriate to the situation and as determined by the
treatment team.
Additional detail regarding screening, assessment, monitoring and response
measures applicable to these areas of risk are found in the site's Abuse
Protection, Reporting and Advocacy, Preventing Crises and Responding
to Behavioral Emergencies and Family and Support Person Involvement
procedures.
Self-Abuse Risk:
Many individuals admitted to the facility have some history of self-harm
behavior that has developed as a coping mechanism for difficult emotional
states. All prospective clients are screened for a history of self-harm. When
a history of self-harm is identified, additional review of the history and
circumstances is done to determine the individual's appropriateness for
admission. If the individual is determined not to be appropriate, referral to
alternative resources is offered and provided. If the individual is admitted,
preventive measures are formulated in collaboration with the patient and
others as appropriate.
Strategies for monitoring risk and preventing self-injurious behaviors
include:
* Collaboration with the patient and family to identify a plan for safety and
reducing risk of self-harm.
* Individualized treatment planning to address the identified concerns.
* Referral to and collaboration with internal or external mental health
treatment resources.
* Referral to medical providers to address actual injury when indicated.
Suicide Risk:
Many individuals admitted to the facility have a history of or are otherwise
at heightened risk of suicide. The Columbia Suicide Severity Rating Scale
(CSSRS) is the clinical tool utilized to assess for and monitor suicide risk of all
52
clients in all treatment programs. Detailed protocols guide the administration
and periodic re-administration of the tool. Workforce are trained in
monitoring for signs and symptoms of suicidality as well as emergency
response procedures in the event of an actual attempt. These detailed
procedures and protocols are contained in the site's Preventing Crises and
Responding to Patient Emergencies and Patient Safety procedures.
Financial Exploitation Risk:
All program workforce members are trained regarding the prohibition on any
personal financial transactions between workforce and clients, including
accepting gifts from clients as described in the corporate policy regarding
Professional-Patient Boundaries. Clear expectations are also communicated
regarding the prohibition on loaning of money and exchanging of personal
property between clients.
Contraband/Use in Treatment Risk:
Contraband
If/When an individual is determined to have a history of bringing
contraband into a facility in previous treatment episodes, or is otherwise
assessed as at risk for contraband, measures will be taken to minimize the
potential for safety risks associated with substances and other contraband
and the resulting risk to safety and risk of atypical discharge.
* All persons entering the facility for programming may be asked to submit
to a search of their person and belongings.
* Program rules and expectations regarding contraband will be explained
to each program participant. This will include a definition of what
contraband consists of, the rationale for why it is considered contraband,
and procedures used to ensure contraband does not come into the facility.
All clients sign a consent to search as part of the Admission and Consent
Agreement.
Substance Use in Treatment
All patients entering Hazelden Betty Ford in Chaska are oriented to the
policies and procedures regarding the implications should someone use
a mood-altering substance while under Hazelden Betty Ford's care, or on
our premises. The following information will be reviewed with each client
entering one of the treatment programs.
* No mood-altering substances are allowed on these premises for any
reason.
* If substances are discovered, they will be appropriately disposed of.
* Urine Drug Screens will be administered periodically to determine if
someone has been using mood altering substances while in care.
* Workforce members are trained to observe client behaviors to include
sight and sound indicators that may suggest someone is under the
influence, and appropriate steps to take should they have such a concern.
* A " Risk Severity Screen " is conducted on each client entering one of
our programs, to include histories that would inform us if there have
been past instances of using while in treatment. This tool is designed to
identify those who have a history of using while in a treatment program,
and the clinicians assigned to the care of such individuals will implement
treatment planning to avoid substance use and atypical discharge.
* All patients who have been identified as using opiates, are given a detailed
*Opiate Warning, to describe the risks associated with overdose or
potential death should they return to use. Naloxone (Narcan) is available in
the facility and all workforce have been trained in its use.
* Procedures are in place to respond to instances of actual substance use
by clients. Additional detail regarding these response procedures may be
found in the site's Impairment/Under the Influence procedure.
Impaired Ability to Communicate Risk:
When it has been identified that a client entering or in our care, struggles
with the ability to communicate vulnerabilities they may be experiencing,
Maple Grove/Chaska Patient Handbook 2023

Table of Contents for the Digital Edition of Maple Grove/Chaska Patient Handbook 2023
