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 ___________________________________________________________________________________ III. People and Personnel Clashes and Solutions • collaborative, concurrent interdisciplinary team • vulnerabilities inhibiting team cohesiveness e.g., recov. vs non-recov.; M.D. vs counselor; psych. vs addictiontrained; biomedical vs psych. orientation; education vs. life experience; ambiguity tolerance • team communication - documentation skills; use of jargon and technical terms e.g., “confused”, “disoriented”, “delusional” • staff-program match • stress of working with multiproblem patients - need to be in control; countertransference; overwhelmed with the needs and lack of resources; group supervision and conflict resolution Incorporate the following into your personal approach to care: • Tolerance: To listen to another professional’s opinion • Open-mindedness: To give up old views of addiction or psychiatric problems • Patience: To explore the history and treatment progress carefully before jumping to diagnostic conclusions • Education: To learn more about addiction & mental illness; meds.; motivating strategies • Serenity: To realize that professionals cannot always know the answers immediately. IV. Policy and Program Clashes and Solutions G. Program Issues • mission of the program, department, institution or agency • equal emphasizes both mental health and addictions issues • admission criteria and patient mix - what can staff/program mange • terminology and treatment tools e.g., “alcoholism vs “addiction • non-cognitive, activity groups e.g., time use charts; collages • groups - education about dual identity; feelings group to learn about relapse cues, signs and symptoms • family involvement; systems work and continuing care • self/mutual help groups - preparation for AA/NA mainstreaming; Dual Recovery Anonymous • staff composition reflects training proportionate to program’s clientele H. Payment Issues • Person-centered funding of services based on the specific priorities guided by the level of functioning in all six ASAM Criteria assessment dimensions • Moving from medical necessity being defined by withdrawal, biomedical and psychiatric severity, to multidimensional severity requiring interventions in any or all of the six dimensions • Fund case management to allow proactive treatment planning rather than reactive services • Turf battles between mental health and alcohol/drug services with addiction services frequently being the more neglected of the two systems due to fewer numbers of clients and/or stigma 4 ______________________________________________________________________________
Cultural Clashes in Co-Occurring Disorders: David Mee-Lee, M.D. Clinical Dilemmas in Assessment and Treatment ___________________________________________________________________________________ I. Gathering Data on Policy and Payment Barriers • Policy, payment and systems issues cannot change quickly. However, as a first step towards reframing frustrating situations into systems change, each incident of inefficient or in adequate meeting of a client’s needs can be a data point that sets the foundation for strategic planning and change • Finding efficient ways to gather data as it happens in daily care of clients can help provide hope and direction for change: PLACEMENT SUMMARY Level of Care/Service Indicated - Insert the level of care and/or type of service that offers the most appropriate level of care/service that can provide the service intensity needed to address the client’s current functioning/severity. Level of Care/Service Received - If the most appropriate level/service is not able to be utilized, insert the most appropriate placement/service available and circle the Reason for Difference between Indicated and Received Level/service Reason for Difference - Circle only one number -- 1. Level of care or Service not available; 2. Provider judgment; 3. Client preference; 4. Client is on waiting list for appropriate level/service; 5. Level of care or Service available, but no payment source; 6. Geographic inaccessibility; 7. Family responsibility problems e.g., no childcare; 8. Language; 9. Not applicable; 10. Not listed. LITERATURE REFERENCES AND RESOURCES Center for Substance Abuse Treatment. Substance Abuse Treatment for Persons With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No. (SMA) 05-3992. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2005 (TIP 42 should be available online within the next couple of weeks. It will be posted to the Health Services/Technology Assessment Text (HSTAT) section of the National Library of Medicine Web site at the following: URL: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.part.22441) Davis KE, O’Neill SJ (2005): “A Focus Group Analysis of Relapse Prevention Strategies for Persons with Substance Use and Mental Disorders”. Psychiatric Services 56:1288-1291 Drake RE, Wallach MA, McGovern MP (2005): “Future Directions in Preventing Relapse to Substance Abuse Among Clients With Severe Mental Illness” Psychiatric Services 56:1297-1302 Mee-Lee, D., Shulman, G.D., Fishman, M., Gastfriend, D.R., & Griffith J.H. (Eds.) (2001). ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition-Revised (ASAM PPC-2R). Chevy Chase, MD: American Society of Addiction Medicine, Inc. American Society of Addiction Medicine - 4601 Nth. Park Ave., Arcade Suite 101, Chevy Chase, MD 20815. (301) 656-3920; Fax: (301) 656-3815; (800) 844-8948. Web page: www.asam.org Mueser KT, Noordsy DL, Drake RE, Fox L (2003): “Integrated Treatment for Dual Disorders – A Guide to Effective Practice” The Guilford Press, NY. Prochaska, JO; Norcross, JC; DiClemente, CC (1994): “Changing For Good” Avon Books, New York. 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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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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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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