COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Controlled Act Research
Fidelity Improves Outcomes
20
ACT better than Standard
ACT not better than Standard
*** If current & subsequent points = 1 then the current score = 1
Assessment Figure Points 1. Percent Baseline of 6 Participants mo. 12 mo. in Stable 18 mo. Remission 24 mo. 30 for mo. High-Fidelity 36 mo. ACT
Hi-Fidelity Programs (E; 0n=61) 19.67vs. Low-Fidelity 26.23 29.51 ACT Programs 37.7 42.62 (G; n=26). 55.74
Low-Fidelity 0 3.85 3.85 7.69 7.69 15.38 15.38
60
17
50
15
Number of Studies
10
5
0
6
Time in
Hospital
8
3
Housing
Stability
7 7
5
Quality of
Life
Client
Satisfaction
1
Percent inRemission
40
30
20
10
0
Baseline 6 mo. 12 mo. 18 mo. 24 mo. 30 mo. 36 mo.
Sacks, S. & Osher, F. 2003. [original reference to follow]
McHugo, et al., 1999
Advice to Counselors and Administrators:
Treatment Principles From ACT
Provide intensive outreach activities.
Use active and continued engagement techniques with clients.
Employ a multidisciplinary team with expertise in substance abuse
treatment and mental health.
Provide practical assistance in life management (e.g., housing) as well
as direct treatment.
Emphasize shared decision making with the client.
Provide close monitoring (e.g., medication management).
Maintain the capacity to intensify services as needed (including 24-hour
on-call, multiple visits per week).
Foster team cohesion and communication; ensure that all members of
the team are familiar with all clients on the caseload.
Use treatment strategies that are related to the client’s motivation and
readiness for treatment, and provide motivational enhancements as
needed.
Adapted from Substance Abuse Treatment for Persons With Co-Occurring Disorders TIP, 2005b
to structure
more flexible activities
shorter meetings &
activities
more staff guidance
more staff
responsibility as role
models
Modified TC
Key Modifications
to process
fewer sanctions
engagement
emphasis
individually paced
progress in program
flexible criteria for
moving to next stage
live-out re-entry
(aftercare) essential
to elements
accent on orientation &
instruction
individualized task
assignments
engagement emphasis
throughout
activities proceed at a
slower pace
counseling to assist use
of community
Summary
The Modified TC is
more flexible
less intense
more individualized
The quintessential elements remain
peer self-help
community-as-method
Adapted from Substance Abuse Treatment for Persons With Co-Occurring Disorders TIP, 2005b
Outcomes baseline vs 2-year
follow-up
3.5
3
2.5
2
1.5
1
0.5
0
Drug
Use
De Leon, G., Sacks, S., et al. 2000.
Modified TC 2
Alcohol
# of
Drugs
Employment
Drug
Use
Alcohol
TAU
# of
Drugs
Employment
baseline
2-year
follow-up
10