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COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 Implementation Drivers CONSULTATION & COACHING PRESERVICE TRAINING STAFF EVALUATION INTEGRATED & COMPENSATORY RECRUITMENT AND SELECTION DECISION SUPPORT DATA SYSTEMS FACILITATIVE ADMINISTRATIVE SUPPORTS SYSTEMS INTERVENTIONS Fixsen, et al. 2005 Staff Time & Place Program Climate Resources Staff Motivation Program Change Model Reception & Utility Stages of Transfer 1-Exposure (Training) • Lecture • Self Study • Workshop • Consultant • Satisfaction • Ease of use • Values fit 2-Adoption (Leadership decision) 3-Implementation (Exploratory use) 4-Practice (Routine use) Institutional Supports Program Improvement (Services/Process/ Management) • Monitoring • Feedback • Rewards Simpson, 2002 Program Climate Resources Staff Motivation Organizational Functioning Climate: • Mission • Cohesion • Autonomy • Communication • Stress • Change Resources: • Offices • Staffing • Training • Equipment • E-Communications Job Attitudes: • Burnout • Satisfaction • Director Leadership Staff: • Growth • Efficacy • Influence • Adaptability Motivation: • Program Needs • Training Needs • Pressures Workplace Practices: • Peer Collaboration • Deprivatized Practice • Collective Responsibility • Focus on Outcomes • Reflective Dialogue • Counselor Socialization Simpson, 2002 Co-Occurring Center for Excellence (COCE) Change Model Inputs (Advances in the field) Resources Available SAMHSA Initiatives NIH Research Change Agents CO- OCCURRING DISORDERS CENTER National Steering Council Project Management Team Project Staff Subcontractors Consultants Technology Transfer Approach Principles: • Relevance • Credibility • Clarity • Feasibility • Psychosocial factors Practices: • Matching goals to readiness • Interpersonal Strategies • Organizational support • Use of: –Translators – Early adopters –Champions • Peer networking • Follow-up and support Targets of Change Norms and Culture of Practice Legislative Regulatory Context COSIG and non-COSIG States Sub-State Entities (Cities, Counties, Tribes, and Tribal Organizations) Providers (community-based, educational establishments, homelessness system, criminal justice, other social and public health) Clinical Practice Outcomes Short Term Long Term Willingness to Science and practice challenge viewed as coequal traditional partners in advancing assumptions patient outcomes Incentives for change Removal of barriers Support of and resources for innovation Interagency communication, cooperation Cross competence Readiness for organizational change and development Support of clinical innovation Readiness for/adoption of innovation Institutionalization of evidence-based practices through reimbursement, licensing, etc. Evidence-based practices as strategic goals Capacity development No wrong door Integrated systems System sustainability Evidence-based practices as organizational norm Evidence-based practices as standard of care Building Blocks for Constructing a Co-Occurring Treatment System Clinical Capacity Evaluation and Monitoring Evidence and Consensus- Based Practices Workforce Development and Training Screening, Assessment, & Treatment Planning Definitions, Terminology, Classification Infrastructure Information Sharing Certification and Licensure Financing Mechanisms Systems Change Services Integration Service & System Change Co-Occurring Center of Excellence (COCE) Type Higher Intensity Technical Assistance Main Outcome Service & System Change Areas Of Emphasis Services & Services Infrastructure Systems Evaluation and Information Sharing Evidence Monitoring and Certification and Consensus- Based Workforce Licensure Practices Development and Financing Mechanisms Screening, Training Assessment, & Systems Change Definitions, Treatment Planning Terminology, Services Integration Classification Approach comprehensive collaborative proactive longitudinal organizational 6
COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 Conclusion References Much has been accomplished in the field of COD in the last 10 years, and the knowledge acquired is ready for broader dissemination and application. The importance of the transfer and application of knowledge and technology has likewise become better understood. New government initiatives (for example, COSIG, COCE, and MHT) are underway that improve services by promoting innovative technology transfer strategies using material that reflect the recent advances in the field. Source: Center for Substance Abuse Treatment. 2005b Addiction Technology Transfer Center (ATTC). 2000. The Change Book: A Blueprint for Technology Transfer. University of Missouri-Kansas City. CSAT: SAMHSA. Alexander, M.J., Sussman, S., & Teleki, A. (2004) Trauma-Informed Screening and Assessment for Women with Co occurring Mental Health and Substance Abuse Problems in Correctional Settings. Center for the Study of Issues in Public Mental Health Nathan Kline Institute for Psychiatric Research Orangeburg, NY 10960. Backer, T. 1991. Drug Abuse Technology Transfer, Rockville, MD: NIDA. Backer, T., David, S.L. & Saucy, G. (eds.) 1995. Reviewing the behavioral science knowledge base on technology transfer. NIDA Research Monograph 155. Rockville, MD: National Institute on Drug Abuse. Carroll, J.F.X, & McGinley, J.J (2004) Guidelines for Using the Mental Health Screening Form III. Presentation to the Screening & Assessment COCE/COSIG Workgroup. De Leon, G., Sacks, S., Staines, G., & McKendrick, K. 2000. Modified therapeutic community for homeless MICAs: Treatment Outcomes. American Journal of Drug and Alcohol Abuse, 26(3), 461-480. Dennis, M.L., White, M.K. & Titus, J.C (2001) Common measures that have been used for both clinical and research purposes with Adolescent Substance Abusers. Chestnut Health Systems, Bloomington, IL Drake, R.E., Mueser, K.T. Brunette, M.F. & McHugo, G.J. (2004). A review of treatments for people with severe mental illnesses and co-occurring substance use disorders. Psychiatric Rehabilitation 27(4), 360-374. References (continued) Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. 2005. Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231). Grant, B.F., Stinson, F.S., Dawson, D.A., Chou, S.P., Dufour, M.C., Comptom, W., Pickering, R.P. & Kaplan, K. (2004) Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders. Archives of General Psychiatry, 61, 807–816. Institute of Medicine 2000. Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. Jeffery, D.P., Ley, A., McLaren, S. & Siegfried, N. 2000. Psychosocial treatment programmes for people with both severe mental illness and substance misuse. The Cochrane Database of Systematic Reviews 2000, Issue 2. Art. No.: CD001088. DOI: 10.1002/14651858.CD001088. NASMHPD and NASADAD (1999). National dialogue on co-occurring mental health and substance use disorders. Washington, DC. References (continued) Lamb, S., Greenlick, M.R. & McCarty, D. (eds.) 1998. Bridging the gap between practice and research. Washington, DC: National Academy Press. McLellan, A.T., Lewis, D.C., O’Brien, C.P., Kleber, H.D. 2000. Drug Dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association, 284(13), 1689-1695.McHugo, G.J., Drake, R.E., Teague, G.B. & Xie, H. 1999. Fidelity to assertive community treatment and client outcomes in the New Hampshire dual disorders study. Psychiatric Services, 50(6), 818-824. Minkoff, K. 2001. Service Planning Guidelines: Co-occurring psychiatric and substance disorders. Fayetteville, IL: University of Chicago, Center for Psychiatric Rehabilitation, Behavioral Health Recovery Management. Online [retrieved 11-10-04] at http://www.bhrm.org/guidelines/ddguidelines.htm Mueser, K.T., Torrey, W.C., Lynde, D., Singer, P., & Drake, R.E. 2003. Implementing evidence-based practices for people with severe mental illness. Behavior Modification, 27(3), 387-411. Office of the Surgeon General. 1999. Report on Mental Health. Publication #017-024-01653-5, Superintendent of Documents, Washington, DC. Rogers, E.M. 1995a. Diffusion of innovations. 4th Edition. New York, NY: Free Press. Rogers, E.M. 1995b. Lessons for guidelines from the diffusion of innovations. Joint Commission Journal on Quality Improvement, 21(7): 324-328. References (continued) Stanley Sacks, Ph.D., Expert Leader, SAMHSA's Co-Occurring Center for Excellence (COCE) Sackett, D.L., Rosenberg, M.C., Muir Gray, J.A., et al. 1996. Evidence-based medicine: What it is and what it isn’t. British Medical Journal, 312, 71-72. Sacks, S. 2000. Co-occurring mental & substance abuse disorders—Promising approaches & research issues. Journal of Substance Use & Misuse 35(12-14), 2061-2093. Sacks, S., Sacks. J.Y., De Leon, G., Bernhardt, A.I. & Staines. G.L. 1997. Modified therapeutic community for mentally Ill chemical abusers: Background; influences: Program description: Preliminary findings. Substance Use and Misuse, 32(9), 1217-1259.Sacks, S. & Osher, F. 2003. Evidence- and Consensus-Based Practices for Clinical Capacity Building. Presented at the COSIG New Grantee Meeting, Washington, DC. Sacks, S., Sacks, J.Y., McKendrick, K., Banks, S., & Stommel, J. 2004. Modified TC for MICA Offenders: Crime Outcomes. Behavioral Sciences & The Law, 22, 477-501. Sacks, S. Melnick, G. & Coen, C. (2006) Co-Occurring Disorders Screening Instrument for Criminal Justice Populations (CJ-CODSI). GAINS Annual Conference, Boston, MA. Substance Abuse and Mental Health Services Administration. 2002.Report to Congress on the Prevention and Treatment of Co-occurring Substance Abuse Disorders and Mental Disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration. Substance Abuse & Mental Health Administration. (2004). Results from the 2003 National Survey on Drug Use and Health: National Findings. Rockville, MD: Office of Applied Studies. Simpson, D.D. 2002. A conceptual framework for transferring research to practice. Journal of Substance Abuse Treatment, 22, 171-182. Contact information: Stanley Sacks, Ph.D. Director, Center for the Integration of Research & Practice National Development & Research Institutes, Inc. 71 W 23rd Street, 8th Floor New York, NY 10010 tel 212.845.4429 fax 212.845.4650 http://www.ndri.org stansacks@mac.com 7
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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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2. There are seven elements in the
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elationship is established with the
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In taking the test, you may find it
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REFERENCES The following resources
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Other Drug Abuse Counselors. Columb
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Stern, T., Herman, J., & Slavin, P.
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2004 PA Certification Board (PCB).
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Prochaska, J.O. & DiClemente, C.C.,
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M12: An Overview of Adolescents and
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G. Benson, 2004 G. Benson 2004 COSI
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M13: Tri-Recovery Process: Improvin
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M15: TIP 42 Treatment for Persons w
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M16: Housing Implications for the O
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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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Page 317 and 318: COSIG Co-Occurring Disorders Confer
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Page 327: TUESDAY May 16 th , 2006
Page 331 and 332: Article by Kenneth Minkoff, MD and
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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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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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W96: Stigma & Co-occurring Disorder
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