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G. Benson, 2004 G. Benson 2004 <strong>COSIG</strong> Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 Perspective of Assessors & Providers BELIEF SYSTEMS THEORETICAL UNDERPINNING & ORIENTATION PHILOSOPHICAL ORIENTATION KNOWLEDGE COMPETENCY SKILLS COMPETENCY ATTITUDINAL POSITIONS LANGUAGE COMMITMENT PURPOSE CURIOSITY HUMILITY Assessment for ALL Disorders is Needed Because. . . • Having one disorder increases the risk of developing another disorder; • The presence of a second disorder makes treatment of the first more complicated; • Treating one disorder does NOT lead to effective management of the other(s); • Treatment outcomes are poorer when co-occurring disorders are present. Gender Differences Latimer, 2002, Robbins, 2002 Males • More common overall • Disruptive disorders • Acting Out •Poly SD Females • Higher rates of depression • Acting In • One drug THE INTEGRATED DIAGNOSTIC FORMULATION/SUMMARY • INTERPRETATION OF COLLECTED DATA – HOW DO YOU UNDERSTAND THE DATA AND BRING MEANING? • ARTICULATES THE SEVERITY OF ILLNESS PROBLEMS ACROSS THE SIX DIMENSIONS INCLUSIVE OF INTERACTIONS BETWEEN DIMENSIONS • IMPRESSIONS, SUSPICIONS & CURIOSITY REGARDING COLLECTED DATA • IDENTIFICATION AND ANALYSIS OF RESILIENCIES, STRENGTHS AND EXECUTIVE EGO FUNCTIONS • IDENTIFICATION AND ANALYSIS OF DEFICITS, RESISTANCES, DEFENSES AND/OR OTHER POTENTIAL INTERFERENCES WITH TREATMENT (E.G., MULTIPLE TREATMENT EPISODES, MULTIPLE RELAPSE HISTORY, TRAUMA/ABUSE ISSUES, CO-OCCURRING/ASSOCIATED DISORDERS, ETC) • PRIORITIZATION OF IDENTIFIED DIMENSIONAL PROBLEMS BY ASSESSED/EVALUATED SEVERITY OF ILLNESS AND IN CONSIDERATION OF POTENTIAL TREATMENT INTERFERENCES/RISKS THEY MAY POSE • ASAM LEVEL OF CARE PLACEMENT IS DETERMINATION BY SEVERITY OF ILLNESS AND “DOSE/INTENSITY” OF SERVICES) REQUIRED IN ACCORDANCE WITH PPC-2R CRITERIA ASAM PPC-2R - Levels of Care • Level .05 - Early Intervention • Level I - Outpatient Treatment • Level II.1- Intensive Outpatient (IOP) • Level II.5 - Partial Hospitalization (PHP) • Level III.1- Clinically Managed Low Intensity Residential TX • Level III.5 - Clinically Managed Med. Intensity Residential TX • Level III.7 - Medically Monitored High Intensity Res./IP TX • Level III.7D - Medically Managed Sub-Acute Detox Res./IP TX • Level IV - Medically Managed Intensive Inpatient TX/Detox ASAM PPC 2R - Dimensions • Dimension 1 - Acute Intoxication/Withdrawal Potential • Dimension 2 - Biomedical Conditions and Complications • Dimension 3 Emotional, Behavioral or Cognitive Conditions and Complications – Co-morbidity » Dangerousness » Interference with addiction recovery » Social functioning » Ability for self-care » Course of illness • Dimension 4 – Readiness to Change • Dimension 5 – Relapse, Continued Use or Continued Problem Potential • Dimension 6 - Recovery Environment 4
<strong>COSIG</strong> Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 Summary of Data For Determining Treatment Needs • Co-Occurring / Co-Morbid Disorder Diagnosis • Severity of Illness & Imminence of Risk • Intensity / Dose of Service Appropriate • Stage of Change/Motivation (ASAM Dim. 4) – (e.g. pre-contemplation, contemplation, etc.) • Utilization Management Criteria – Monitoring of treatment process for change Summary of Data, Cont. • Determination of Multidisciplinary Treatment Team and Support Systems Resources Needs – (e.g.: case manager, peer supports, family, etc.) • Individual capacities, strengths, resources, and interests and appropriate modifications & accommodations necessary to meet individual needs • Involvement & Case Management of Collaborative / Collateral Systems – (e.g.: juvenile justice, child protective system, school, etc.) 5
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Program Description: The Commonweal
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Conference Information: The Pennsyl
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MONDAY May 15 th , 2006
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Monday Morning Plenary Session “S
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COSIG Co-Occurring Disorders Confer
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M01: The Addiction Psychiatry Couns
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5. Criminal Logic: This is a 3- to
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12 Roadblocks of Communication 1 Or
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3 G.R.A.C.E. G- For Gap. Often our
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5 _________________________________
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7 Overall, what do you gain by drug
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9 2. What time of day would be best
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11 10. What good things would happe
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13 Decisional Balance for Drug Use
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15 ________________________________
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17 Drug use: Antecedents, Consequen
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Certificate of Achievement Temple U
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M06: An Overview: Co-Occurring Diso
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Requirements for CCDP Employment CC
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ecertification cycle (PCB approved
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Work Experience Verification Applic
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Code of Ethical Conduct UNLAWFUL CO
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psychoactive substance impairs the
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Easy Pass for PCB credentialed prof
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CCDP Checklist for applicants with
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TABLE OF CONTENTS Purpose of the Ca
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confidentiality in substance abuse
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Task 4 - Recognize signs and sympto
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individual’s needs and circumstan
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and community resources and service
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3. Social supports and networks for
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COUNSELING Task 1 - Provide a safe,
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CASE MANAGEMENT information. Task 1
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ensure continuity of care whenever
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disciplinary codes of ethics and st
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2. Effective public relations techn
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2. Eliciting accurate evaluation da
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Page 152 and 153: REFERENCES The following resources
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DRAFT - Community Based and Recover
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are perceived as necessary for stat
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esponsibility shared with consumers
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or provided at other rehab programs
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Supportive housing is a successful,
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Living on the Edge: Substance Use a
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M26: Dual Recovery: 12-Step Program
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Using Dialectical Behavior Therapy
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Using Dialectical Behavior Therapy
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TUESDAY May 16 th , 2006
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Article by Kenneth Minkoff, MD and
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RESOURCE BIBLIOGRAPHY (2005) 1. Ame
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38. Foundation Associates, Making M
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71. Minkoff K & Cline C, Developing
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co-occurring psychiatric and substa
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T31: Implementing Evidence-Based Pr
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T32: Berks County Adolescent Pilot
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T35: CCISC Implementation in Pennsy
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Volume 1, Issue 5 The Trainers meet
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Volume 1, Issue 1 BLAIR COUNTY’S
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Volume 1, Issue 1 Vision/Mission CO
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Volume 1, Issue 1 3. The population
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Volume 1, Issue 1 Complete
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Volume 1, Issue 1 The forgoing Cons
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Volume 1, Issue 1 Language for Inte
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Volume 1, Issue 1 Language for Inte
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T36: The Co-Occurring Distinction:
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Integration or Occupation? •QUEST
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Coming to a Balance “Rather shall
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T41: Offering Positive Incentives t
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Motivational Incentives for Enhance
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T43: Prison to Community: Reducing
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T45: Workforce Issues and Co-occurr
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T46: Creation of Local Housing Opti
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Fetal alcohol spectrum disorders fo
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MY 9-YR-OLD SON’S HISTORY OF MEDI
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Don’t Ask My Child to Fly Bruce R
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1 Multisystemic Therapy MST Model H
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3 NCFAS RESULTS: Adolescents & Pare
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Adelphoi Village Multisystemic Ther
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DISCHARGES PER AGENCY TOTAL DISCHAR
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T53: Using Change Theory to Assess
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The following questionnaire is desi
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THE STAGES OF CHANGE APPLIED TO COU
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T55: Creating Co-Occurring Centers
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12. What is the diagnosis: |___| 1
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Fact Sheet A Project to Establish A
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Planning and Implementing a Welcomi
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All organizations signing this memo
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3. Region I organizations will assi
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e) Link organizations with websites
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Planning and Implementing a Welcomi
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Welcome to the Johnson Institute ht
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johnsoninstitute.com - History http
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johnsoninstitute.com - President's
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MISA PILOT TAKES FLIGHT: A PILOT AP
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In Flight Changes for COD in Washin
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Crisis & Counseling Centers Co-occu
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Fact Sheet A Project to Establish A
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Mental Health Network Co-Occurring
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100% Treatment Team Improvement in
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T67: Antisocial Personality Disorde
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Wednesday Morning Plenary Session
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Cultural Clashes in Co-Occurring Di
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W72: Use of Animal Assisted Therapy
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W74: Therapy for Women Facing Traum
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HIEN, COHEN, MIELE, ET AL. for the
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HIEN, COHEN, MIELE, ET AL. TABLE 2.
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HIEN, COHEN, MIELE, ET AL. TABLE 4.
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W75: The MISA/COD Pilot Projects: L
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THE BEAVER COUNTY MODEL • Targets
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Additional Information Contact: Nan
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W76: Friends Connection Peer Suppor
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W77: Treatment for Older Adult with
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W81: The Pennsylvania COSIG Evaluat
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W83: Beaver County Forensic COD Ini
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W84: Improving Assessment and Treat
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Improving Assessment and Treatment
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W86: Fairweather Lodge - An Evidenc
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Housing, Employment, Social and Aut
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Principle VI. Successful Lodges res
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Fidelity to Autonomy Principles 1.
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W87: Physical Disorders and Persons
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W91: Collaborative Care for Concurr
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W96: Stigma & Co-occurring Disorder
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