297 Special Series -Counseling People with Co-Occurring Disorders SAMHSA TIP 42 Part 3

Summary: Treatment of Persons with Co-Occurring Disorders Based on SAMHSA TIP 42 Part 3 Host: Dr. Dawn-Elise Snipes Executive Director: AllCEUs Counselor Education Podcast Host: Counselor Toolbox and Addiction Counselor Exam Review Objectives ~ Identify guiding principles in treatment ~ Identify core components in the delivery of services ~ Explore how to improve substance abuse treatment systems and programs Guiding Principles ~ For each component, identify how you do, or could apply this in your program ~ Employ a recovery perspective ~ Adopt a multiproblem viewpoint ~ Develop a phased approach to treatment ~ Address specific real-life problems early in treatment ~ Plan for the client’s cognitive and functional impairments ~ Use support systems to maintain and extend treatment effectiveness ~ Community ~ Family ~ Self-Help Core Components ~ For each component, identify how you do, or could apply this in your program ~ Access ~ Full assessment ~ Appropriate levels of care ~ Integrated treatment ~ Comprehensive Services ~ Continuity of care Access ~ Access occurs in four main ways: ~ Routine access for individuals seeking services who are not in crisis ~ Crisis access for individuals requiring immediate services due to an emergency ~ Outreach, in which agencies target individuals in great need (e.g., people who are homeless) who are not seeking services or cannot access ordinary routine or crisis services ~ Access that is involuntary, coerced, or mandated by the criminal justice system, employers, or the child welfare system Assessment ~ Screening to detect the possible presence of COD in the setting where the client is first seen for treatment ~ Evaluation of background factors (family, trauma history, marital status, health, education and work history), mental disorders, substance abuse, and related medical and psychosocial problems (e.g., living circumstances, employment, family) that are critical to address in treatment planning ~ Diagnosis of the type and severity of substance use and mental disorders ~ Initial matching of individual client to services (often, this must be done before a full assessment is completed and diagnoses clarified; also, the client's motivation to change with regard to one or more of the co-occurring disorders may not be well established) ~ Appraisal of existing social and community support systems ~ Continuous evaluation (that is, re-evaluation over time as needs and symptoms change and as more information becomes available) Appropriate Level of Care ~ A basic program has the capacity to provide treatment for one disorder, but also screens for the other disorder and can access necessary consultations. ~ A program with an intermediate level of capacity tends to focus primarily on one disorder without substantial modification to its usual treatment, but also explicitly addresses some specific needs of the other disorder. ~ A program with an advanced level of capacity provides integrated substance abuse treatment and mental health services for clients with COD. ~ A program that is fully integrated actively combines substance abuse and mental health interventions to treat disorders, related problems, and the whole person more effectively Integrated Treatment ~ Integrated treatment can occur on different levels and through different mechanisms. For example: ~ One clinician delivers a variety of needed services. ~ Two or more clinicians work together to provide needed services. ~ A clinician may consult with other specialties and then integrate that consultation into the care provided. ~ A clinician may coordinate a variety of efforts in an individualized treatment plan that integrates the needed services. ~ Multiple agencies can join together to create a program that will serve a specific population. Integrated Treatment ~ The focus is on preventing anxiety rather than breaking through denial. ~ Emphasis is placed on trust, understanding, and learning. ~ Treatment is characterized by a slow pace and a long-te