issues settings models of care for persons with co occurring disorders
Download
Skip this Video
Download Presentation
Issues, Settings & Models of Care for Persons with Co-occurring Disorders

Loading in 2 Seconds...

play fullscreen
1 / 18

Issues - PowerPoint PPT Presentation


  • 284 Views
  • Uploaded on

Issues, Settings & Models of Care for Persons with Co-occurring Disorders. Arthur J. Cox, Sr., DSW, LCSW “2005 National Forum on Clinical Skill Building for Co-occurring Disorders September 22-23, 2005 Orlando, FL. Arthur J. Cox, Sr., DSW, LCSW. President/CEO

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Issues' - Ava


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
issues settings models of care for persons with co occurring disorders

Issues, Settings & Models of Care for Persons with Co-occurring Disorders

Arthur J. Cox, Sr., DSW, LCSW

“2005 National Forum on Clinical

Skill Building for Co-occurring

Disorders

September 22-23, 2005 Orlando, FL

arthur j cox sr dsw lcsw
Arthur J. Cox, Sr., DSW, LCSW
  • President/CEO
  • The Mid-Florida Center for Mental Health and Substance Abuse Services, Inc.
  • P. O. Box 33
  • Avon Park, FL 33826
  • (863) 452-6818
  • Fax (863) 452-6617
  • E-mail: [email protected]
  • Website: www.midfloridacenter.com
cod resources
COD Resources
  • SAMHSA’s Co-Occurring Center for Excellence atwww.coce.samhsa.gov
  • Co-Occurring Dialogues Discussion List: Membership is free and unrestricted and can be done by sending an e-mail to [email protected]
  • Co-Occurring State Incentive Grants (COSIG) and Policy Academies: see SAMHSA website for information at www..samhsa.gov
  • Reports (see COCE website)
mfc a fully integrated treatment organizations for co occurring disorders
MFC:A Fully Integrated TreatmentOrganizations for Co-occurring Disorders
  • One program that provides treatment for both disorders.
  • Client’s mental and substance related disorders are treated by the same clinicians.
  • Clinicians are continuously cross-trained to treat multiple disorders.
  • Focus is on preventing anxiety rather than breaking through denial.
  • Agency offers stagewise & motivational counseling.
  • 12 Step support groups attendance are required or available.
  • Psychiatric evaluations and psychpharmacotherapies are available
coce core products and services
COCE Core Products and Services
  • The COCE Web Site www.coce.samhsa.gov
  • Overview papers, technical reports, and other products
  • Technical Assistance

Direct requests to:

Email: [email protected]

Phone: 301-951-3369

  • Meetings and conferences
  • Pilot evaluation of the Performance Partnership Grant (PPG) measure
overview of co occurring disorders
Overview of Co-occurring Disorders
  • Prevalence & Trends
  • Heterogeneity & Special Populations
  • Shift towards Integrated Assessment and Treatment
  • Effective approaches, Models & Strategies
  • Training Needs
  • Recent Development at Federal, state and community levels
slide7
Use
  • drink / use to be social and on social occasions (sometimes referred to as social or recreational use)
  • occasionally drink or use for the intoxicating effects
  • drink / use occasionally, for example a couple of times a month to a couple of times per year
  • typically drink 1 - 2 drinks per drinking occasion, sometimes more; may leave drinks unfinished
  • drink or use to intoxication only occasionally; episodes of intoxication do not interfere with life functioning
  • have never experienced life problems as a result of drinking or using
abuse
ABUSE
  • drink or use for the effect of feeling drunk or high
  • frequently drink to intoxication and use to the point of significant impairment
  • have experienced at least one life problem associated with the use of drugs or alcohol
  • continue to use despite life problems associated with using
  • are starting to experience increased tolerance to alcohol and drugs of abuse
  • often drink or use alone in order to avoid hassles from family or friends
  • drink or use on weekends in order to avoid disruptions to work or school schedules
  • engage in illegal activity related to use; arrests / legal problems resulting from use
  • See TIP 42, PP 22-23, Burton, Cox & Fleisher-Bond, 2001
dependence
DEPENDENCE
  • drink or use because of a compulsion, (i.e. “have to”)
  • drink or use constantly, often daily
  • almost always drink to intoxication and use to the point of significant impairment
  • drink or use to avoid withdrawal
  • have experienced numerous problems in several areas of life functioning and continue to use despite these problems
  • suffer from the disease of addiction, marked by loss of control
  • have marked tolerance to alcohol and drugs of abuse
  • may experience withdrawal when use is discontinued
  • TIP 42, P.23, Burton, Cox, & Fleisher-Bond, 2001, P. 23
defining loss of control
Defining Loss of Control
  • using more than intended or over a longer period of time than intended
  • unsuccessful efforts to reduce, control or discontinue use, (i.e. being unable to keep promises to self and others to quit, relapsing following treatment interventions)
  • excessive time spent getting substances, using them and/or recovering from their effects
  • continuing to use despite the presence of intense physical and/or psychological problems created or worsened by use (APA, 1994), TIP 42, PP 21-23.
physiological dependence
Physiological Dependence
  • increased tolerance: requiring more and more of a substance in order to get the desired effect, (i.e. “I used to catch a buzz on one or two beers, now I can drink a six pack and not really feel it.”); decrease in the desired effect when the same amount of a substance is taken (APA, 1994)
  • withdrawal: experiencing physical symptoms of the withdrawal syndrome for the specific substance taken upon discontinuing use; the symptoms cause impairment in functioning; continuing to use a substance in order to avoid withdrawal (APA, 1994)
mental disorders
Mental Disorders

. Disorders are defined by:

  • sets of symptoms that,
  • occur over time, and
  • lead to an inability to function the way a person wants to or is required to.
  • Further, they do not occur exclusively during the course of substance use, and
  • are not better accounted for by medical conditions
classifying mental disorders
Classifying Mental Disorders
  • Psychotic Disorders: schizophrenia, all types; other psychotic disorders
  • Mood Disorders: depressive disorders, all types; bipolar disorders, all types
  • Anxiety Disorders: phobias, PTSD, generalized anxiety disorder, panic disorder
  • Behavioral Disorders: personality disorders, all types (clusters A, B, and C)
  • TIP 42, PP23-26, Burton, Cox, Fleisher-Bond 2001, PP 35-42
quadrants of care
QUADRANTS OF CARE
  • Category I –Mental & substance related disorders are both less severe –primary health.
  • Category II – 50% of behavioral health clients – mental disorders – cmhc
  • Category III – Majority of COD – SA/MH/Jails
  • Category IV – Chronic MI/SA - ???
  • Figure 2-1 Tip 42, p29
components of integrated treatment basic competencies
Components of Integrated Treatment: Basic Competencies*

What Substance Abuse Professionals

Need to Know

  • the nature of mental disorders and their development
  • symptomatology of mental disorders and other functional disorders
  • psychosocial difficulties resulting from mental disorders
  • the necessity of psychotherapeutic medications in the treatment of mental illness
  • effective psychiatric treatment interventions
  • substance abuse treatment interventions that may prove detrimental to persons with mental disorders
components of integrated treatment
Components of Integrated Treatment

What Mental Health Professionals

Need to Know

  • the nature of addictive disorders and their treatment
  • symptoms and hallmarks of addictive disorders
  • psychosocial difficulties that arise from chronic substance use
  • psychotherapeutic agents that may prove detrimental to persons with substance-related disorders
  • effective substance abuse treatment interventions
  • mental health treatment interventions that may prove detrimental to persons with substance-related disorders
what professionals from both fields need to know
What Professionals from Both Fields Need to Know
  • the nature of substance abuse and mental illness as they co-occur
  • strategies for meeting the special treatment needs of persons with co-occurring disorders
  • basic competencies for assessing other functional disorders that impact the clinical picture
  • strategies for offering treatment interventions for other functional disorders
  • strategies for assessment and differential diagnosis; assessing for ‘multiple disorders’
  • common myths and misconceptions about co-occurring disorders
  • methods for blending treatment interventions and developing competent programming
  • comprehensive understanding of relapse when disorders co-occur
  • how best to assess / treat special populations (women, youth the elderly, alternative lifestyle, HIV/AIDS, persons of color)
questions
Questions
  • Questions and Comments from attendees
ad