Treatment services

Formal inspection programs present a good opportunity for the water treatment service company representative to undertake an informal internal inspection to observe the various boiler surfaces first hand, perhaps undertake some limited nondestructive testing (NDT) work, and record the results of the previous 12 months water treatment management program. 

For larger plants some water analysis, results interpretation, and recommendations for operational changes may be carried out by a boiler operator, water treatment plant technician or a laboratory analyst (or even by an outsourced subcontractor) these recommendations complement similar work undertaken by the water treatment service company representative. 

NOTE In practice, the skills required to correctly and comprehensively interpret the various water analyses and provide suitable recommendations for action are not widely available outside the ranks of the service companies. When selecting a water treatment service provider therefore, this element should factor significantly in the vendor evaluation process. 

To achieve this objective at the operational level, consistently good water treatment practice is required on site. However, achieving this objective cannot and should not be the sole prerogative or responsibility of any one person. Rather, if success is to be attained and maintained, it requires a proactive approach with joint participation, support, and communication by the water treatment service company and the owners and/or operators of the boiler plant. 

However, most other types of organizations (such as the millions of commercial, institutional, and industrial buildings and facilities globally) do not produce water or steam as a primary product. Rather, they focus on their own market arenas, with the result that, by and large, they lack adequate skilled water treatment expertise and resources internally. These industries therefore employ water treatment service companies as specialist contractors. 

Consequently, all water treatment service companies provide several phosphate-based formulations in their product range, from which a particular phosphate-alkalinity combination can be selected. These formulations typically employ one of the following phosphate types ... 

Every water treatment service company has several dual-function or multifunction programs in their BW product range based on chelant, phosphate, or polymer. Which of these particular chemistries takes the lead position depends on the type of waterside problems likely to be encountered (in some ways this is related to the particular market sector) and the positioning of the company within the overall BW treatment marketplace. 

Looking further at the second group, although many of the larger, non-utility operators around the world retain a resident water services chemist or trained technician, there is a marked tendency for all owners or operators, whether large or small, to work in conjunction with a water treatment service company. There is also a common purpose to use branded BW treatment chemical products rather than commodities. 

With the smallest heating boilers or low volume/low pressure steam producers, water treatment service companies tend to promote easy-to-understand programs, typically based on only one or two multiple-component, blended chemical products (multiblends or one-drum treatments), or increasingly, the novel crystalline solid concentrates (solid water treatment). These customers often have only very limited, water-related, in-house technical skills, and multiblend product programs will seem attractive because they are relatively easy to apply. However, the blending process makes it notoriously difficult to control individual component reserves in the boiler and generally adds considerably to the overall program costs. 

Traditionally, customers employ water treatment service companies simply as external contractors to assist in the maintenance of clean and efficient waterside surfaces in their various heating, steam generating, cooling, and certain industrial process systems. The customers benefit from genuine improvements in operating efficiency, reductions in maintenance time, and replacement component costs. In addition, where industrial processes are involved they often profit from an added-value, due to an improved product quality or reduction in manufacturing cost. 

It is a fact of life that the cost of providing water treatment services increases with the size and complexity of boiler plant. This cost may be recovered with larger boiler plants by the higher volumes of chemical treatments sold, as often the chemical selling prices will include an allowance for all the anticipated (and expensive) technical service time requirements. 

Another LCI-related issue is allocation. This is especially relevant to waste treatment options when waste is recycled or used to generate energy, there is a multi-output process which needs to be dealt with. The waste then is no longer considered a waste, but a resource, and waste treatment is becoming a production process as well. What part of the emissions to allocate to the waste treatment service and what part to the secondary material or other co-product is then open to debate. ISO allows for various options. Whether additives are even visible in such processes is, again, doubtful. 

Doka G (2007) Life cycle inventories of waste treatment services. Part I, II and III. Ecoinvent report no. 13. Ecoinvent, St-Gallen, Switzerland, http //www.ecoinvent.ch/... 

The greatest hope for intervening upon a drug problem is treating the factors we know how to change at the present, which are mainly psychological and environmental. Because drug problems may look different from one person to the next, therapists and counselors must individualize treatment services to serve... 

Making a proper referral is an art form, one part of which — the when and why to make a referral — was discussed in the previous chapter. Another part of that artistry involves making the referral in an appropriate way. For the sake of simplicity, there are certain dos and don ts related to making an appropriate referral. For example, do make referrals in a timely fashion. Our clients often need help quickly when a referral is necessary. Delay can harm progress. Related to this, do make sure that you have your client sign a release so that you can talk with another professional about the client, and do make sure there is little to no lapse in treatment services between referral to appointment. 

Another way to include collaterals is to offer treatment services to them as well. Many treatment facilities offer such services, which may include family support groups or even individual therapy for family members of clients. Some treatment centers include family therapists specifically for these purposes. Sometimes counselors and therapists will refer family members to outside support groups, which may include Al-Anon or Alateen 12-step programs for family and friends. Family therapy may include assessment, sometimes using similar measures discussed earlier for assessing client needs, in order to more adequately help family members with their needs. In some cases, these assessments may be used to develop a family treatment plan or an individualized treatment plan for a family member. 

Bruininks, R.H., Hill, B.K., and Morteau, L.E. (1988) Ptevalence and implications of maladaptive behaviots and dual diagnosis in tes-idential and othet service programs. In Stark, J.A., Menolascino, F.J., Albarelli, M.H., and Gray, V.C., eds. Mental Retardation and Mental Health. Classification, Diagnosis, Treatment, Services. New York Springer-Verlag, pp. 3-29. 

Hoagwood, K., Kelleher, K.J., Feil, M., and Comer, D.M. (2000) Treatment services for children with ADHD a national perspective. J Acad Child Adolesc Psychiatry 39 198—206. 

A decision to temporarily or permanently exclude a patient from a drug treatment service or provide coerced detoxification should not be taken lightly. Such a course of action can put the patient at an increased risk of overdose death, contracting a blood-borne virus or offending. It may also increase the level of risk to children and vulnerable adults in the home. If at all possible, patients excluded from a service should be offered treatment at another local service or setting in a way that minimizes risks and maximizes opportunities for patients to be retained in treatment. 

In this advice there is not even any exclusion regarding individuals who have simply been abusing the treatment service, for instance (as happened to us recently) by storing huge quantities of take-home methadone in their house as part of their dealing activities. 

Reviewing her history, it appeared that she had used heroin by injection for five years before being first prescribed methadone. She was from a relatively isolated small town where the limited network of users had few links with treatment services. She used heroin with her then husband, and both were eventually referred to the clinic after he had been charged with supplying the drug. They separated soon afterwards, and while he remained in treatment for only a short period before leaving the area, Amanda has been receiving prescribed medication since that time. 

---