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ManualofOperationsfor
DrugAbuseTreatmentand
RehabilitationCenters

DepartmentofHealth
Sta.Cruz,Manila

1ManualofOperationsforDrugAbuseTreatmentandRehabilitationCenters

Page2

TABLEOFCONTENTS

Page
Chapter1

INTRODUCTION
LegalBasis
GeneralObjective
SpecificObjective
Application

ChapterII

ORGANIZATIONANDPERSONNEL4
Organization
ClassificationofDrugAbuseTreatmentand
RehabilitationCenters
PersonnelRequirement
GeneralQualificationsforallPersonnel
DutiesandResponsibilities

ChapterIII

EQUIPMENTANDPHYSICALPLANT8
Equipment/Instruments
PhysicalPlant
GuidelinesinPlanningandDesignofTreatment
AndRehabilitationFacilities

ChapterIV

CLINICALOPERATIONSANDSERVICES17
ClinicalGuidelines
PrescribedServices
RecommendedTreatmentApproaches/Modalities
RecommendedTherapeuticActivities

ChapterV

ADMINISTRATIVEANDOTHERSUPPORT
SERVICESGUIDELINES
RecordsManagement
FiscalManagement
Security
PersonnelManagement
MaintenanceProgram
TrainingProgram
DietaryManagement
StatisticalReport

ChapterVI

PATIENTRIGHTS

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Chapter1

22

25

INTRODUCTION

ThisManualofOperationsforDrugAbuseTreatmentandRehabilitationCentersshall
serveasstandardreferencematerialtoaidadministratorsandpractitionersinthe
managementandoperationsofthedifferentdrugtreatmentandrehabilitationcentersin
thePhilippines.ThisManualpresentstheminimumstandardsforfacilities,servicesand
resourcesrecommendedbytheDepartmentofHealth(DOH)forthistypeofhealthcare
facility.ThesesamestandardswillbeuniformlyappliedbytheDOHasbasisfor
accreditationofDrugAbuseTreatmentandRehabilitationCentersintheCountry.
LegalBasis:
RepublicAct9165,otherwiseknownasComprehensiveDangerousDrugActof2002,
mandatestheDepartmentofHealthtoregulate,overseeandmonitortheintegration,
coordinationandsupervisionofalldrugrehabilitation,intervention,aftercareandfollow
upprograms,projectsandactivitiesaswellastheestablishment,operations,maintenance
andmanagementofDrugAbuseTreatmentandRehabilitationCentersnationwide.
GeneralObjective:
Toensureefficientandeffectivedeliveryofdrugabusetreatmentandrehabilitation
services.
SpecificObjective:
1.ToestablishandmaintainacceptablestandardsforoperationofDrugAbuse
TreatmentandRehabilitationCenters.
2.Toprovideusefulinformationfordecisionmaking,administrativeplanningand
development.
3.Toprovidestandardsandguidefortheaccreditationandmonitoringofdrugabuse
treatmentandrehabilitationservicesinthecountry.
Application:
ThisManualshallbeusedbyallDrugAbuseTreatmentandRehabilitationCentersinthe
Philippinesbothgovernmentandnongovernmentownedoroperated.FortheDOHto
issueaCertificateofAccreditation,compliancetothestandardsandguidelinesembodied
inthisManualisrequired.Higherlevelsorqualityofcareshallbeacceptableonlyifthe
recommendedminimumstandardspresentedinthisManualhavebeenmet.

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Chapter2
ORGANIZATIONANDPERSONNEL

Organization:
Thefacilityshallbealegallyconstitutedentity.Forasingleproprietorship,itmustbe
registeredwiththeDepartmentofTradeandIndustryandforacorporateentity,itmust
beregisteredwiththeSecuritiesandExchangeCommission.

ItsorganizationandstructureshallcontributeeffectivelytothegoalsofRepublicAct
9165.Itshalldevelopbroadcommunityandprofessionalacceptanceinorderto
implementthegoalseffectively.
Theorganizationshallclearlydefinethepurpose,scope,directionandgoalsofthe
Center.ItshalldocumentanddisseminatetheCentersvalues,visionstatement,mission
andphilosophy.
ClassificationofDrugAbuseTreatmentandRehabilitationCenters:
1.Ownership
1.1Governmentoperatedandmaintainedpartiallyorwhollybythenational,
provincial,cityormunicipalgovernment,oranyothergovernmentagency
1.2Privateprivatelyowned,establishedandoperatedwithfundsthrough
donation,principal,investmentorothermeans,byanyindividual,
corporation,associationororganization.
2.InstitutionalCharacter
2.1InstitutionbasedaCenterthatoperateswithinanyinstitution.
2.2FreestandingaCenterthatoperatesseparatelyfromanyotherinstitution.
3.ServiceCapability
3.1NonresidentialTreatmentandRehabilitationCenter(OutpatientCenter)a
healthfacilitythatprovidesdiagnosis,treatmentandmanagementofdrug
dependentsonanoutpatientbasis.Itmaybeadropin/walkinCenterorany
otheroffice/facilityusedbysupportgroupsthatprovideconsultationor
counselling.Fromtimetotime,itmayprovidetemporaryshelterforpatients
incrisisfornotmorethantwentyfour(24)hours.
3.2ResidentialTreatmentandRehabilitationCenter(InpatientCenter)ahealth
facilitythatprovidescomprehensiverehabilitationservicesutilizing,among
others,anyoftheacceptedmodalities:MultidisciplinaryTeamApproach,
TherapeuticCommunityApproachand/orSpiritualServicestowardsthe
rehabilitationofadrugdependent.

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PersonnelRequirement:
GeneralQualificationsforallpersonnel:
1.Mustbedrugfree
2.Musthavenopendingadministrativeorcriminalrecords
3.Mustbementallyandphysicallyfit
4.Withgoodmoralcharacter
5.Ifforeigner,workingpermitissuedbytheBureauofImmigrationandDeportation
isrequired.
A.NonResidentialTreatmentandRehabilitationCenter
1.One(I)DOHAccreditedPhysician(PartTime)
DutiesandResponsibilities:
a.Responsibleforthediagnosisandtreatmentofdrugdependents
b.Overseestheaftercareandfollowupofrecoveringdrugdependent
c.Makesthenecessaryreferral
d.Attendstocourthearing,writesmedicalreports
e.Supervisesallclinicalpersonnel(nurses,socialworker,psychologist)
f.Ensuresadequateandaccurate,timelinessofreports
g.Performsotherdutiesandfunctionsthatarerelevanttotheposition

2.One(1)LicensedNurse
DutiesandResponsibilities:
1.Providesappropriatenursingcaretoallpatients
2.Preparesstatusreportsofallpatients
3.Assiststhephysicianinthetreatmentprocess
4.Conductsgroupandindividualcounsellingsessions
5.Administersmedicationasprescribedbythephysician
6.Conductsrelevantantidrugabuseprogramwithinthecatchmentarea
7.Performsotherdutiesandfunctionsthatarerelevanttotheposition.
3.One(1)LicensedSocialWorkerand/orPsychologist(Parttime)
DutiesandResponsibilities:
a.Assiststhephysicianinthetreatmentprocess
b.Doesregularvisitationtoeverypatient
c.Providescounsellingtopatientsandtheircodependents
d.Followupdomiciliaryservicestopatients
e.Responsiblefordevelopingaftercareandfollowupprogramforsocial
worker
f.Doessocialcasestudyofallpatients
g.Conductspsychologicaltestingandevaluationwhenrequiredfor
psychologist
*Intheabsenceofapsychologistinthecenter,patientsshouldbereferred
toatrainedpsychologistforpsychologicaltesting.
h.Performsotherdutiesandfunctionsthatarerelevanttotheposition.

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4.One(1)Clerk
DutiesandResponsibilities
a.Gatherspertinentdataofpatientsandconductsintakeinterview
b.Encodes/typesreportsand/orreferralstobesubmittedincourtsandother
agencies
c.Ensurescleanlinessandorderlinessintheoffice
d.Ensuresconfidentialityofallrecordsofpatients
e.Performsotherdutiesandfunctionsthatarerelevanttotheposition
B.ResidentialTreatmentandRehabilitationCenter
1.One(1)Center/ProgramDirector/Administrator
a.Minimumofthree(3)yearsexperienceasrehabilitationworker
b.Adequatetrainingnotonlyonthemodalitybeingutilizedbutalsoother
trainingpertinenttotreatmentandrehabilitationand/orbackgroundinany
behaviouralsciencesand
c.Atleasttwo(2)yearscollegeeducation
d.Ifformerdrugdependent,mustbedrugfreeforthree(3)years
DutiesandResponsibilities:
a.DirectlyresponsibleforthedaytodayactivitiesandneedsoftheCenter
b.Coordinatesallmedical,social,psychological,andspiritualservicesofthe
Center
c.Overseestheentirerehabilitationprogram
d.Responsiblefortheresidentialneeds,maintenance,upkeepandsecurityof
theCenter
e.ResponsibleforthepersonnelmanagementoftheCenter
f.ProvidespolicydirectionfortheCenter.
2.One(1)DOHAccreditedPhysician(Oncall)
DutiesandResponsibilities:

a.Directlyresponsibleforthediagnosis,treatmentofallmedical,minor
surgical,psychologicalproblemsofpatients
b.Overseestheentiretreatmentprocess
c.Responsibleforwritingprogressreportandsubmitmedicalreportsandother
pertinentdocuments
d.Incoordinationwithotherstaff,he/sherecommendsfordischarge,transferor
referralofpatients
e.Performsotherdutiesandfunctionsthatarerelevanttotheposition.
3.One(1)LicensedDentist(onCall)
DutiesandResponsibilities
a.Attendstoalldentalreferrals
b.Performsotherdutiesandfunctionsthatarerelevanttotheposition
4.One(1)LicensedNurse/Midwiferatio:1nurse/midwifeforevery50patients
DutiesandResponsibilities:
a.Assiststhephysicianinthetreatmentprocess
b.Doesregularvisitationtoeverypatient
c.Administersmedicationasprescribedbythephysician
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d.Providescounsellingtopatients
e.Attendstoemergencycases
f.Performsotherdutiesandfunctionsthatarerelevanttotheposition
5.One(1)LicensedSocialWorkerratio:1licensedsocialworkerforevery50
patients
DutiesandResponsibilities
a.ConductssocialcasestudiesforalladmittedpatientsintheCenter
b.Assessthesocialstatusofthepatient
c.Responsibleforhousevisits
d.Conductscounselling
e.Performsotherdutiesandfunctionsthatarerelevanttotheposition.
6.One(1)Psychologistratio:1psychologistforevery50patients
DutiesandResponsibilities:
a.Responsibleforpsychologicaltestingandevaluationforalladmittedpatients
b.Providespsychologicalcounselling
c.ConductspsychologicalandbehavioralprogramoftheCenter
d.Performsotherdutiesandfunctionsthatarerelevanttotheposition.
7.One(1)Clerkratio:1clerkforevery100patients
DutiesandResponsibilities:
a.Ensuresconfidentialityofallrecordsofpatients
b.Ensurescleanlinessandorderlinessintheoffice
c.Performsotherdutiesandfunctionsthatarerelevanttotheposition.
8.NonprofessionalStaffratio:4nonprofessionalstaffforevery100patients
DutiesandResponsibilities:
a.Supervisesthepreparationofwellbalanceddietofthepatients
b.Maintainsthecleanlinessandorderlinessofthefacility
c.Goesonperiodicduty
d.Providessecurity
e.Performsotherfunctions/tasksasassigned

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Chapter3
EQUIPMENTANDPHYSICALPLANT

Equipment/Instruments
A.NonResidentialTreatmentandRehabilitationCenter
1.Bench
2.Cabinetwithlock
3.ClinicalWeighingScale
4.ExaminingTable
5.Examininglight
6.Sphygmomanometer
7.Stethoscope
8.table/chairs
9.Telephone
10.Computerand/ortypewriter
B.ResidentialTreatmentandRehabilitationCenter
1.Bedsordoubledeckedbedsoritssuitableequivalentonebedforevery
patient
2.Cabinetandlocker
3.Diningtable
4.Electricfan
5.emergencymedicalcabinet/firstaidkit
6.examininglight
7.fireextinguishers
8.recreationalequipment
9.refrigerator
10.sofaset
11.sphygmomanometer
12.stethoscope
13.stove
14.tablesandchairs
15.telephone
16.thermometer
17.TVand/orkaraoke
18.typewriter/computer
19.weighingscale
PhysicalPlant
ADrugAbuseTreatmentandRehabilitationCentershallbeexclusivelyforthetreatment
andrehabilitationofdrugdependents.TheCentershallnotprovideservicestopatients
withprimarypsychoticbehaviour.Patientsexhibitingpsychosisasaresultor
consequenceofcertaindangerousdruguseshallbereferredtoapsychiatriccarefacility.
However,patientswithborderlinepsychosismaybeadmittedorbeallowedtostayinthe
Centerprovidedthatthereisapsychiatristsorderandifitposesnoharmtotheother
patients.

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A.NonResidentialTreatmentandRehabilitationCenter
TheCentershallhaveatleastafloorareaoftwentyfive(25)squaremetersforthe
following:
1.BusinessArea
2.Consultation,examinationandtreatmentroomwithlavatory/sink
3.Toiletwithlavatory
4.Multipurposeareathatcandoubleasthereception/waitingareaand
meetingareaforgroup/family
B.ResidentialTreatmentandRehabilitationCenter
Thecentershallhaveatleast400squaremeters(for30patients)forthefollowing:
1.Registrationarea/waitingarea/reception
2.Counselling/testingroom
3.Administrativeoffice/Directorsoffice(withsecuredstoragefiles)
4.Emergencyclinicmustbelocatedneartheareawherethecenter
personnelareonduty
5.Livingquarters,separateroomsformaleandfemale
6.Toilet/bath/lavatoryoneforevery10patients
7.Multipurposearea/recreationalarea
8.Diningarea
9.Kitchenareawithprovisiontosecure/lockallsharpobjects
10.Areaforoutdooractivity
GuidelinesinthePlanningandDesignofTreatmentandRehabilitationFacilities:
a.Thesizeofthefacilitymustbeadequatefortheintendedusethebuilding
shallbewellventilatedandspaciousforoccupantstoberelatively
comfortabletoallowprivacyforthemedicaltreatmentarea,counsellingand
groupactivities.Thelandareamustwheneverpossiblehaveenoughspace
forsportsandrecreationandlearningactivities.
b.Thebuildingshouldmeetconstructionandsafetystandards,aswellfire
regulationandhealthandsanitationrequirements.
c.BathroomandtoiletsThereshallbeatleastonebathroom,onetoilet,and
onelavatoryisingoodworkingconditionsforeveryten(10)patients.The
bathroomandtoiletsshallnotbeprovidedwithlocksexceptthoseforthe
exclusiveuseofadministrativestaff.
d.Kitchenshallbecleanatalltimesandshallbeequippedwithadequatebasic
cookingutensilsandfoodstorageandwithprovisiontosecure/locksall
sharpobjects.
e.Diningareashallbeclean,welllighted,protectedfrominsectsandvermins,
cheerfullydecoratedandshallbeprovidedwithchairsandtables.
f.Forresidentialfacilitieswithbedrooms,therequirementsare:
1.Thebedshallbeplacedatleast100cm.orone(1)meterapart.
2.Ifadoubledeckedbedisutilized,thisshallhaveatleastonemeterspace
fromtheceilingandagainbetweentheupperandlowerbeds.
3.Thebedroomshallbecleanandorderlyatalltimes.
g.Emergencyclinicshallaccommodatepatientswhoarephysicallysick.It
mustbewellsecured,spaciousenoughforatleasttwopatientsandwith
provisionfortheirpersonalhygieneandexcretoryfunctions.Itmustbe
visiblyaccessibleforthosewhoareonduty.

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h.Adequatewatersupplyandelectricitymustbeavailabletotheextent
possibletheremustbetelephoneandothermeansforoutside
communication.

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GUIDELINESINTHEDESIGNOFNONRESIDENTIALTREATMENTANDREHABILITATIONCENTER
MinimumofTwentyFive(25)SquareMetersinFloorArea
Area
Activity
People
Equipment
Furniture
FloorArea
andFixture
inSquareMeters
PatientReception
receivingof
clerk
bench
7.00
patient
chair
Area/Group
client
(accommodate
group
parents/
officetable
MeetingArea
5personsata

Planning
Relationship
immediately
accessibleto
client

Consultation,
Examinationand
TreatmentRoom
andPsychological
TestingArea

counseling,
educationand
therapy
followupand
aftercare
program
drugabuse
assessment
and
management
emergency
assistancefor
drug
withdrawal
and
psychiatric
illness

guardians
physician
psychologist/
socialworker

patient
nurse
physician

giventime)

clinical
weighingscale
examining
light
examining
table
sphygmomano
meter
stethoscope
psychological
testing
materials

chair
officetable
lavatory
medicine
cabinet

7.43

locatednear
entranceofthe
facility

adjacentto
patient
receptionarea/
groupmeeting
area

_____________________________________________
1 RefertoAnnexA:PrototypeFloorPlanofNonresidentialTreatmentandRehabilitationCenter
2 Basedon1.40m2 /person(unitareaperpersonoccupyingthespaceatonetime)
3 Clearfoorareaperexaminingtablethatincludesspaceforpassageofequipment

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Area

Activity

People

Toiletwith
lavatory

managingof
personal
hygiene

clerk
patient
nurse
physician
psychologist/
socialworker

BusinessArea

performance
ofpersonnel,
accounting,
records,
supply
and
housekeeping

clerkr

Equipment

computer
printer
typewriter
telephone

_____________________________________________
4 Workareaperstaffthatincludesspaceforachairandadesk,spaceforoccasionalvisitor,andspaceforaisle.

12ManualofOperationsforDrugAbuseTreatmentandRehabilitationCenters

Furniture
andFixture
lavatory
watercloset

cabinet
chair
officetable

FloorArea
inSquareMeters
1.67

5.02

Planning
Relationship
separatetoilet
andhand
washing
facility
adjacentto
consultation,
examination
andtreatment
room
locatednear
entrance

Page13

GUIDELINESINTHEDESIGNOFRESIDENTIALTREATMENTANDREHABILITATIONCENTER
MinimumofFourHundred(400)SquareMetersinFloorArea
Area
Activity
People
Equipment
Furniture
FloorArea
andFixture
inSquareMeters
receivingof
clerk
bench
Registration
7.00
Area/Waiting
patient
patient
chair
(accommodate
physician
officetable
Area/Reception
5personsata
psychologist
giventime)
socialworker
patient
clinical
bed
EmergencyClinicdrugabuse
7.43
physician
lavatory
assessment
weighingscale
and
nurse
examining
management
light
emergency
examining
assistancefor
table
sphymomano
drug
withdrawal
meter
and
stethoscope
thermometer
psychiatric
illness

Planning
Relationship
immediately
accessibleto
client
locatednear
entrance
adjacentto
patient
receptionarea

_____________________________________________
5 RefertoAnnexB:PrototypeFloorPlanofResidentialTreatmentandRehabilitationCenter

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Area
Counselingand
TestingRoom

LivingQuarters
(female)with
Toilet

Activity
drugabuse
assessment
and
management
individual
counseling,
educationand
therapy
followupand
aftercare
program
lodging
storingof
personal
belongings
managingof
personal

People

Equipment

patient
nurse
physician

Psychological
Testing
Materials

patient

electricfan

Furniture
andFixture
Armchairs
Officetable

bed
cabinet

FloorArea
inSquareMeters
7.43

111.45
(accommodate
15personsata
6
giventime)

Planning
Relationship
adjacentto
patient
receptionarea

segregatedfor
privacy

LivingQuarters
(male)withToilet

hygiene
lodging
storingof
personal
belongings
managingof
personal
hygiene

patient

electricfan

bed
cabinet

111.45
(accommodate
15personsata
giventime)

segregatedfor
privacy

FloorArea
inSquareMeters
42.00
(accommodate
30personsata
7
giventime)
4.65

Planning
Relationship
adjacentto
kitchen

_____________________________________________
6 Basedon7.43m2 /bed(clearfloorareaperbedthatincludesspaceforsinglebed,spaceforoccasionalvisitor,andtoilet)

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Area

Activity

People

Equipment

Furniture
andFixture
chair
table

DiningArea

takingof
meals

patient

electricfan

Kitchen

coldanddry
storage
food
preparation
cookingand
baking
servingand
foodassembly
washing
group
counseling,
educationand
therapy
rehabilitation
followupand
aftercare
program

cook
cookingaide

electricfan
refrigerator
sink
stove

cabinet
counter

patient
physician
psychologist/
socialworker

electricfan
karaoke
television

chair
table

Multipurpose
Area/Recreational
Area

adjacentto
diningarea

42.00
(accommodate
30personsata
giventime)

accessible
fromfemale
andmaleward

FloorArea
inSquareMeters
42.00
(accommodate30
personsatagiven

Planning
Relationship
accessible
fromfemale
andmaleward

_____________________________________________
7 Basedon1.40m2 /person(unitareaperpersonoccupyingthespaceatonetime)

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Area
OutdoorActivity
Area

Activity
group
counseling,
educationand

People
patient
physician
psychologist/

Equipment

Furniture
andFixture
bench

therapy
rehabilitation
followupand
aftercare
program
managingof
personal
hygiene

Toilet

performance
ofpersonnel,
accounting,
records,
supplyand
housekeeping

Administrative
Office

socialworker

time)

clerk
nurse
physician
psychologist/
socialworker

administrator
clerk

Computer
Fire
extinguisher
Printer
telephone

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Chapter4
CLINICALOPERATIONSANDSERVICES
ClinicalGuidelines
NonResidentialTreatmentandRehabilitationCenter
1.Intakeinterviewsandhistorytakingmustbeaccomplishedimmediatelyupon
contactwithpatientsandorrelativeofpatients.Itmustincludeatleastthe
followinginformation:generaldata,presentingproblem,referralinformationand
druginventory.
2.ADOHaccreditedphysicianmustconductdrugdependencyexamination
immediately.
3.Theintakeinterviewandhistorytakingshallbedonebyasocialworkerin
preparationforasocialcasestudyreport.
4.Psychologicalevaluationreportsmustbedonewithintwo(2)weeksfrom
admission.
5.Allpatientsrequiringmedicalevaluationandexaminationmustbeseenand
examinedwithinthree(3)daysaftertheinitialintake.
6.Findingsandevaluationmustbedocumentedandproperlyfiledintheindividual
patientcasefile.
7.Appropriateinformationreferralnotesshallbeaccomplishedwhenreferring
patientstootheragencies.Itmustatleastincludethefollowing:generaldata,
reasonsforreferral,actionsalreadytakenintheCenter.
8.Alltherapeuticsinterventionmustbeproperlydocumentedtoincludeamong
otherslistofmedicines,dosage/frequencyofintake.
9.Progressnotesmustbeproperlydocumented.
10.Diagnosticproceduresthatincludespsychologicalevaluation,alltestresultse.g.
chestxray,laboratoryexaminations,drugscreeningtestmustbeproperlyfiledin
thepatientcasefile.
11.Thecentershallmaintainindividualcasefilefolderforeachpatient,which
containscourtorders,communicationsandotherdocumentswhichmaybe
pertinenttothepatients.

lavatory
watercloset

1.67

cabinet
chair
officetables

10.04

separatetoilet
andhand
washing
facility
accessible
from
consultation,
examination
andtreatment
room
accessible
from
administrative
office
immediately
accessibleto
patient
locatednear
entranceofthe
facility

12.Family/groupsessionsincludingsessionswiththecommunityshallbeproperly
documentedandfiledinaseparatefolder.
ResidentialTreatmentandRehabilitationCenter
1.Intakeinterviewmustbedoneimmediatelyuponcontactwithpatient,relativeof
patientorreferringperson.Itshouldincludeatleastthefollowinginformation:
generaldata,presentingproblem,referralinformation,anddruginventory.
2.Allreferralsformedical,surgical,psychiatricproblemsmustbeseenbytheDOH
accreditedphysicianwithintwentyfour(24)hours.
3.Allmedicalfindingsmustbedocumentedandproperlyfiledintheindividual
patientcasefolder.Likewise,allmedicalordersforprocedures,medicationsand
otherinterventionshouldbeproperlydocumentedandfiled.
4.Requireddiagnosticproceduressuchaschestxray,sputumexamination,
urinalysisECGforpatient45yearsoldandabove,mustbedonewithin24hours
afteradmissions.
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5.Psychologicalreportsandsocialcasestudiesmustbedonewithintwoweeksfrom
admission.Thismustbeproperlyfiledintheindividualpatientcasefolder.
6.Alltreatmentplan/interventionshouldbeproperlydocumentedwhichshould
includemedicationsdose,frequencyandduration.
7.Progressnotesshallbedoneforallcasesatleastonceamonth.
8.Dischargeplanshouldalsobedocumented.
9.Accidents,incidentreports,escapereportsshallbeaccomplishedwithineight(8)
hoursoftheeventandshouldincludedetailsonthefollowing:who,what,where,
when,actionstakenanddisposition.
10.Allpertinentdocumentsrelatedtopatientssuchascommunications,courtorders
shouldbeproperlyfiledineachpatientscasefolder.
11.Allmedicalreportsandotherdocumentssubmittedtocourtshallbeproperlyfiled
inthepatientscasefolder.
12.Rehabilitationservicethatincludestreatmentmodalities,counsellingprogram,
recreationalprogram,familyprogramandotherservicesshallbeproperly
documented.
PrescribedServices:
1.MedicalServiceprovidescomprehensivehealthcareservicesrangingfrom
routinephysicalexaminationandscreeningprocedurefordiagnosis,
treatmentandfollowupofillnessesandothermedicalproblems.
2.Psychiatricserviceprovidestherapytodrugabuserswithbehaviouraland
psychiatricdisordersthrough,amongothers,pharmacotherapy,individual
andgrouppsychotherapy,familytherapyandoccupationaltherapy
conductedbyapsychiatricteam.Apsychiatricteamshallincludea
psychiatrist,psychologistandsocialworker.Thismayincludean
occupationaltherapistandparaprofessionalworker.
3.Psychologicalserviceassiststheteamintheassessment,diagnosisand
managementofdrugsdependentsthroughpsychologicaltestingand
evaluationaswellasinconductingtherapy/counsellingtopatientsand
theirfamilies.
4.Socialserviceassiststhedrugdependentshelpthemselvescopetheir
problems,facilitateand/orpromotetheirinterpersonalrelationshipand
adjustmenttothedemandsofatreatmentprogramwiththeendviewof
helpingthedrugdependentsphysical,social,moralandspiritual
development.
5.Spiritualandreligiousservicesincludethedevelopmentofmoraland
spiritualvaluesofthedrugdependent.Ithasbeennotedthatthespiritual
foundationofclientshasbeenveryweakthatthiscouldnotprovide

supporttothemtoenablethemtocopewiththeirproblemsandconflicts.
Strengtheningthespiritualfoundationwouldinvolve,amongothers,
reorientationofmoralvalues,spiritualrenewal,biblestudyandother
charismaticsessions.ItaimstobringthemclosertoGodandbetterrelate
totheirfellowmen.Variousreligiousandcivicorganizationscanbe

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contactedtoprovideservices.Spiritualcounsellingshallbehelpfulin
aidingandresolutionofindividualandfamilyproblems.
6.Referralserviceinvolvestheprocessofidentifyingaccuratelythe
problemsoftheclientandsendinghimtotheagencythatcanprovidethe
appropriateservices.
7.Sportsandrecreationservicesprovidefacilitiesforsportsandrecreationto
offerpatientstheopportunitytoengageinconstructiveactivitiesandto
establishpeerrelationshipasanalternativetodrugabuse.Theemphasisin
allactivitiesshouldbeondevelopingthedisciplinenecessarytoimprove
skillsandongainingrespectforgoodphysicalhealth.
8.Residential/housecareserviceincludesprovisionofbasicfoods,clothing
andshelter.
9.AftercareandFollowupServicesprovidedtothepatientaftertheprimary
rehabilitation.Aftercareactivitiescanbeviewedasthefirstlineof
defenceagainstrelapse.Theactivitiesincludeattendingselfhelp
programslikeNarcoticsAnonymous(NA)/AlcoholicAnonymous(AA)
meetings,regularfollowupattreatmentcenter,individualandgroup
counselings,sponsor/sponseemeetings,alumniassociationmeetings,etc.
Thisisforaperiodnotexceedingeighteen(18)monthsandshouldbe
undertakenbytheappropriateCenterpersonnel.
AdditionalServices(Optional)
1.Placementserviceprovidesassistancetodrugdependentsinobtaining
workopportunitiesthroughopen,self,and/orshelteredemployment.
2.VolunteerServiceassiststheorganicstaffofthecentertoperform
rehabilitationtreatmentservicesand/oradministrativefunctionsbutdonot
receivecompensation.Itincludesrecruitment,selectionandappointment
oftheseindividualsand/ororganizedgroupsandtrainingondrugabuse
preventionandrehabilitation.Theservicesofvolunteersaremonitoredand
evaluated.Volunteersmayincludeprofessionals,paraprofessionals,
parentsandyouthorganizations.Theymayperformfunctionswhichmay
includepatientmanagementsuchascasefindings,management,medical,
psychiatric,psychologicalandsocialservices.Paraprofessionalsservices
includeadministrative,sportsandrecreationincludingspiritualandmoral
developmentservices.Organizedparentsgroupsmayextendpeerparent
counsellingorsupportiveencounters.Youthgroupsvolunteersmay
provideselfhelpassistance,peergroupconfrontationsandsupportand/or
peerministriescounsellingtodrugdependentsattheCenter.
3.Educationalopportunitiesshallbemadeavailabletopatientswhileinthe
centerforthepurposeofimprovingtheirskills,interestsandcapabilities
onaparticularvocationalfieldoftheirchoice.Thisaimstoincreasetheir
selfesteemandtheirchanceforemployment.Thismayimprovetheir
workhabitsandthusmakepossibleamoresatisfactoryandrewardingway
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oflife.Theeducationalopportunitiescomefromabuiltinschooling
programandvocationaltrainingcoursethattakesintoaccountprevailing
conditionsinthelocallabormarket,theeconomyofthecommunity,the
industrialandcommercialneedsofthecommunity.

RecommendedTreatmentApproaches/Modalities:
1.MultidisciplinaryTeamApproachisamethodinthetreatmentand
rehabilitationofdrugdependentswhichavailsoftheservicesandskillsof
ateamcomposedofpsychiatrist,psychologist,socialworker,occupational
therapistandotherrelateddisciplinesincollaborationwiththefamilyand
thedrugdependent.
2.TherapeuticCommunityApproachviewsaddictionasasymptomatic
manifestationofamorecomplexpsychologicalproblemrootedinan
interplayofemotional,social,physicalandspiritualvalues.Itisahighly
structuredprogramwhereinthecommunityisutilizedastheprimary
vehicletofosterbehaviouralandattitudinalchange.Thepatientreceives
theinformationandtheimpetustochangefrombeingapartofthe
community.Rolemodellingandpeerpressureplaysignificantpartsinthe
program.
Thegoalofeverytherapeuticcommunityistochangethepatientsself
destructivethinkingandbehaviouralpattern,teachthempersonal
responsibility,positivizetheirselfimage,createasenseofhuman
communityandprovideanenvironmentinwhichhumanbeingscangrow
andtakeresponsibilityandcreditforthegrowth.
3.HazeldenMinnesottaModelviewsaddictionasadisease,aninvoluntary
conditioncausedbyfactorslargelyoutsideapersonscontrol.The
programconsistsofdidacticlectures,cognitivebehavioralpsychology,
AlcoholicAnonymousprinciples/TwelveStepsprinciplesandbiblio
therapy.Itaimstotreatpatientswithchemicaldependency,endorsinga
setofvaluesandbeliefsaboutthepowerlessnessofpeopleoverdrug
takingandturningtoaHigherPowertohelpthemcombatthedisease.In
thismodality,counsellorsandpatientscollaborateindefiningthepathto
recovery.
4.SpiritualApproachusestheBibleastheprimarysourceofinspirationto
change.Itviewsdrugaddictionasasinandencouragesthepatientsto
turnawayfromitandrenewtheirrelationshipswiththeLord.
5.EclecticApproachaimsatapplyingaholisticapproachinthe
rehabilitationprogram.Thespiritualandcognitivecomponentsofthe
TwelveStepscomplementthebehaviouralaspectsoftheTherapeutic
Community.Theskillsandservicesofrehabilitationprofessionalsand
paraprofessionalsaremadeavailable.Indoingso,differentpersonality
aspectsofdrugdependentsarewelladdressedgearedtowardstheir
rehabilitationandrecovery.
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RecommendedTherapeuticActivities
1.Psychotherapyisaformoftreatmentofproblemsofanemotionalnature

inwhichatrainedpersondeliberatelyestablishesprofessionalrelationship
withapatientwithobjectofremedying,modifyingorretardingexisting
symptoms,mediatingdisturbedpatternsofbehaviour,andpromoting
positivepersonalitygrowthanddevelopment.
2.CounsellingisaprocessofassistanceextendedbyCenterPersonnel,inan
individualorgroupsituation,toaneedypatient.Theprocessaimsat
enablingtheindividualtolearnandpursuemorerealisticandsatisfying
solutionstohisdifficulties.Itisproblemorientedandhelpstheindividual
understandhimselfanddeveloptheabilitytotakedecisionsandmake
choices.
3.IndividualTherapyinvolvesaonetoonerelationshipbetweenthe
counsellorandthepatientwiththeprimaryaimofhelpingtheclientgetrid
ofareducehisdrugabusingbehavioursothathemaybeabletoget
involvedinproductiveworkanddevelopinsightsintohisconditions.
4.GroupTherapyisaformoftherapywheretheindividualishelpthrough
groupprocess.Eachmemberofthegroupreceivesimmediatefeedback
fromtheothermembersregardinghisverbalandotherformsofbehaviour.
Groupsupportandencouragementaregiventothesubjectonthepremise
thattheseareeffectivedevices,whichcanproducepositiveresultstoward
behaviouralmodification.
5.FamilyTherapyasaformofinterventionisbasedontherecognitionthat
thefamily,asaprimarysocialunit,canbeasourceofproblemleadingto
druguse.Familytherapymayincluderestructuringofthefamily,
environmentalmanipulation,strengtheningoffamilycommunicationand
discoveryoffamilymemberstohelpfacilitatetherehabilitationofthe
drugdependent.
6.CommunityWorkProjectsincludeamongothers,environmentaland
energyconservationprojects,traininginagriculture,treeplantingand
othersociocivicreligiousactivities.Theparticipationofpatientsin
communityprojectscanhelpthemintegrateintothelocalsocietyandcan
alsopromotecommunityunderstandingoftheirneedsandrecognizeof
theirremainingpotentialandacceptance.
7.ShelteredWorkshopprovidestrainingforskillsdevelopmentand
employmentwithappropriatecompensationinacontrolledenvironmentto
increaseselfesteemandchancesforoutsideplacement.
8.SocialReintegrationisaprocessofassistingthepatienttobecomesocially
andeconomicallyselfsustainingwithouttheuseofdrugsuponhisreturn
tothecommunity.

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Chapter5
ADMINISTRATIVEANDOTHERSUPPORTSERVICESGUIDELINES
RecordsManagement
TherecordsroomshallbesecuredbyreadilyaccessibletoCenterpersonnel.Records
shallbekepttoallowcarefulandsystematicmanagement.
Patientfilesshallincludereferral,socialcasehistory,homevisits,psychologicaltest
evaluationresults,laboratoryresults,medical/psychiatricevaluationandtherapy,
progressnotes,escapeofpatients,otherformsofmisdemeanour,outcomeofcase
conference,recommendationofstaff,discharge,followupandaftercarereleasesas

wellasclosurereports.DocumentationofservicesshallbepartofCenterrecord.
Confidentialityofrecordsshallbemaintainedatalltimes.
Administrativefilesshallincludethosecommunicationspreparedorreceived,fiscal
andmanagementdocuments,recordsofallprocurementofsupplies,buildingand
otherfacilitiesandtheoutsideenvironmentwithinthecompound.Personnelfileshall
likewisebepartoftheadministrativefiles.Itshallincludecompleteanduptodate
recordsofallpersonneldata,employmentagreement,jobdescription,leaves,periodic
performance,evaluationandmedicaltreatment,transfer,retirementandrecordsof
administrativecharges,ifany.
FiscalManagement
TheCentershallhaveasoundplanoffinancingwhichgivesassuranceofsufficient
fundstoenableittocarryoutitsdefinedpurposeandprovideappropriateservicesfor
drugdependents.AnewCentershallhavereasonableassuranceofsufficientfundsto
carryitthroughthefirstyearofoperation.Fundsshallbeprovidedforemployee
benefitsrequiredbylaw.TheCentershallsubmittheirannualfinancialreport.
Theparent,spouse,guardianoranyrelativewithinthefourthdegreeofconsanguinity
ofanypersonwhoisconfinedunderthevoluntarysubmissionprogramorcompulsory
submissionprogramshallbechargedacertainpercentageofthecostofhis/her
treatmentandrehabilitation,followingtheDepartmentofSocialWelfareand
Developments(DSWD)guidelinestakingintoconsiderationtheeconomicstatusof
thefamilyofthepersonconfined.
AllprivateresidentialCentersshallallocatefive(5)percentofthetotalbedsfor
servicepatients.Governmentresidentialcentersmustnotexceedfiftypercentofthe
totalbedallocationforpayingpatients.Discountedratesshallbebasedonthe
prescribedguidelinesbytheDSWD.
Security
TheCentermustbeadequatelysecuredtoensuresafetyfromoutsideintrusionandto
preventescapesofpatientsandtoensureadrugfreeenvironment.Theremustbea
fenceandplantbarriersaroundthearea.Visitorsshallbeproperlyscreenedand

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controlled.Asystemofsearchingfordangerousdrugsanditemsmustbeclearly
documentedandimplemented.
PersonnelManagement
TheCentermusthaveasoundsystemofrecruitment,selectionandappointmentof
personneltoensurethatstaffiscompetentandqualifiedtoperformtheservices.
Individualfile(201)shallbemaintainedtoincludepersonaldatasheet,service
records,credentials,performanceevaluation,etc.
MaintenanceProgram
Thecentermusthaveapreventivemaintenanceplan.Upkeepandmaintenanceof
facilityandequipmentincludingvehiclesshallberegularlyconducted.
TrainingProgram
Allstaffmustkeepabreastwithcurrenttrendsintreatmentandrehabilitation
programs.Toensuretheenrichmentofknowledgeandskillsenhancementofstaffin
thespecializedareaofrehabilitation,theCentermusthaveatrainingprogramforall
thepersonnel.TheCentermustallowattendanceofitspersonneltoappropriate
trainingprograms.Allmembersofthetechnicalstaffofthecenterincluding
volunteersshallundergotraining.Thetrainingshallconsistsofpreservicetraining

forfuturemembersofthestaff,continuousinserviceorinhousestafftrainingfor
administrativeandclinicalstaff.
DietaryManagement
TheCentershallensureprovisionofawellbalanceddietandmeetingthedaily
caloricneeds.Itshallrespectthespecialdietaryneedsofthepatient.
StatisticalReport
TheCentershallgeneratethefollowingdata:
1.Demographicprofileofpatientsthatincludes,age,sex,religion,occupation,
address,educationalattainment,socioeconomicstatus,drugofabuse,average
familyincome.
2.Admissions/dischargesclassifiedasfollows
a.Completed
b.Dischargesagainstmedicaladvice
c.Transferred
d.Escapes
e.Readmissions/Relapse
f.Courtcommittedvoluntaryandcompulsory
3.Mortality/Deaths
a.Accident
b.Illness
c.Suicide

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4.Morbidityclassifiedasfollows
a.Accident
b.Illness
c.AttemptedSuicide
5.Patientsundergoingaftercareandfollowupprogram
6.Patientsatisfactionsurvey/complaints
ThesemiannualstatisticalreportshallbesubmittedtotheBureauofHealthFacilties
andServices.

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Chapter6
PATIENTRIGHTS
PatientRightsduringTreatmentandRehabilitation
1.Patientsaremadeawareoftheirrights.Thisshallbeachievedbybutisnot
limitedto:
1.1Informationiscommunicatedinawaythatisreadilyunderstoodbythe
patientandrepeatedasnecessary.
1.2Informationonpatientrightsisdisplayedprominentlyinanappropriate
areawithintheCenter.
1.3Patientsareinformedwhenpersonalinformationiscollectedfromthem,
whytheinformationisneededandwhomitwillbedisclosedto.Patients
havetherighttoseekaccesstoandcorrectionofanypersonal
informationheldaboutthem.
2.Informationisprovidedandcommunicatedinaformatbestsuitabletothe
individualpatientandtheirfamily.
3.TheCentershallprovidepatientsandtheirfamiliesaccurateandadequate
informationaboutserviceoptionstoenablethemtomakeaninformed
decision.
4.TheCentershalldefineandobservetheextentofpatientrightstopersonal
privacyanddignityduringtreatmentandrehabilitation.
CulturalSafety
1.TheCentershallidentify,prepareforandrespondtotheculture,valuesand
beliefsofthepatientsduringtheirstayinthefacility.
2.TheCentershallrespecttheroleofthefamilyinmaintainingapatients
valuesandbeliefs.
Confidentiality
1.TheCentershallidentifyandcommunicateitsobligationstothepatientand
familyinrelationtomaintainingconfidentialityanddefinesthesituations
whereitisnecessarytodiscloseinformationaboutthepatient.

2.TheCentershallhaveproceduresthatensurerelevantandnecessary
informationaboutthepatientisdisclosedamongserviceproviders,andacross
relevantcomponentsofinpatientandcommunityservices.
3.TheCentershallhaveasysteminplace,whichensuresthesecurityofpatient
relatedinformation.

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4.CopiesoftheCenterspoliciesonconfidentialityincludingtheprocessfor
dealingwithbreachesofconfidentialityareavailableonrequest.
5.Allstaffsignsaconfidentialityagreementuponemploymentandshallrespect
patientinformationasconfidential.
InformedChoiceandInformedConsent
1.TheCentershallhavepolicies/proceduresforgatheringanddocumenting
informedchoiceandinformedconsentfrompatientsandrelatives.
2.TheCentershallhaveproceduresforgaininginformedchoiceandinformed
consentforspecificsituations.
PhysicalPrivacy
1.TheCentershallprovideadequatephysicalprivacy.
2.TheCentershallensurethatstaffrespectsprivacyandpersonalspaceof
patients.
3.TheCentershallensurethatpatientshavevisualprivacywhenattendingtoor
securingassistancewithpersonalhygienerequirements.
4.TheCentershallensurethatpatientsareabletohaveprivateinteractionwith
familymembers,whenappropriate.
5.TheCentershallensurethatpatientsareabletoreceivetelephonecallsin
private,whenappropriate.Intimeswhenforsecurityreasonscallsmayneed
tobemonitored,patientsareinformedonthis.
DisciplinaryMeasures
1.TheCentershallensurethatdisciplinarymeasuresarehumaneandsafetothe
patients.
2.TheCentershallprohibittheuseofsex,anyformofviolenceandlife
threateningdisciplinarymeasures.
3.TheCentershallensurethatuseofrestraintsiscoveredbydoctorsorders.
Nopatientisrestrainedformorethansix(6)hourstoavoidmedical
complications.

26ManualofOperationsforDrugAbuseTreatmentandRehabilitationCenters