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

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Cultural Clashes in Co-Occurring Disorders: David Mee-Lee, M.D. Clinical Dilemmas in Assessment and Treatment ___________________________________________________________________________________ 3. Care versus Confrontation • mental health - care, support, understanding, passivity • addiction - accountability, behavior change 4. Abstinence-oriented versus Abstinence-mandated • treatment as a process, not an event • respective roles in both approaches 5. Deinstitutionalization versus Recovery and Rehabilitation C. Dilemmas in Definition, Diagnosis and Disposition • Definition - diagnosis or diagnoses; “multiproblem” - any client who presents with significant alcohol and/or other drug use and active psychiatric Sxs • Diagnosis - substance use disorder or psychiatric diagnosis or both?; primary or secondary disorder, or doesn’t it matter? • Disposition - where to treat? - addiction treatment settings; mental health settings; or special dual diagnosis services; use treatment-priority to determine placement - how to treat? - medications; motivation; meetings D. Why Diagnostic Confusion? - Diagnostic Confusion due to: • Alcohol/drugs can cause psychiatric symptoms in anyone (acute toxicity) • Prolonged alcohol/drug use can cause short or long-term psychiatric illness • Alcohol/drug use can escalate in episodes of psychiatric illness • Psychiatric symptoms and alcohol/drug use can occur in other psychiatric disorders • Independent addiction and psychiatric illnesses (“Dual Diagnosis”) (Marc A. Schuckit: Am. J. Psychiatry, 143:2 p. 141 - modified) E. Why Lack of Consensus? • Lack of consistency in research findings; research methodologies; prevalence rates • Different training and experience • Different patient populations • Different research methodologies 2 ______________________________________________________________________________
Cultural Clashes in Co-Occurring Disorders: David Mee-Lee, M.D. Clinical Dilemmas in Assessment and Treatment ___________________________________________________________________________________ II. What to do about Philosophical Clashes F. Person-Centered Assessment and Individualized Treatment 1. Multidimensional Assessment • Because mental and substance-related disorders are biopsychosocial disorders in etiology, expression and treatment, assessment must be comprehensive and multidimensional to plan effective care. The common language of six assessment dimensions of the ASAM Criteria (modified for mental disorders in Second Edition, Revised, ASAM PPC-2R, 2001) are used to focus assessment and treatment. 1. Acute intoxication and/or withdrawal potential 2. Biomedical conditions and complications 3. Emotional/behavioral/Cognitive conditions and complications 4. Readiness to Change 5. Relapse/Continued Use/Continued Problem potential 6. Recovery environment 2. Individualized Treatment PATIENT/PARTICIPANT ASSESSMENT Data from all BIOPSYCHOSOCIAL Dimensions PROGRESS Response to Treatment BIOPSYCHOSOCIAL Severity (SI) and Level of Functioning (LOF) PRIORITIES BIOPSYCHOSOCIAL Severity (SI) and Level of Functioning (LOF) PLAN BIOPSYCHOSOCIAL Treatment Intensity of Service (IS) - Modalities and Levels of Service 3. Biopsychosocial Treatment - Overview: 5 M’s * Motivate - Dimension 4 issues; intervention; “raising the bottom”; motivational enhancement * Manage - the family, significant others, work/school, legal * Medication - detox; anti-craving meds; Antabuse; opioid antagonists; methadone and buprenorphine; psychotropic medication * Meetings - AA, NA, Al-Anon; Smart Recovery, Dual Recovery Anonymous, etc. * Monitor - continuity of care; relapse prevention; family and significant others 4. Treatment Levels of Service - levels of care/service to match severity of problems: I Outpatient Services II Intensive Outpatient/Partial Hospitalization Services III Residential/Inpatient Services IV Medically-Managed Intensive Inpatient Services 3 ______________________________________________________________________________
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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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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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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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