Dual Diagnosis 101 Meeting the Behavioral Healthcare Needs of Persons with Intellectual and Developmental Disabilities and Co-occurring psychiatric Diagnoses (IDD/MI). Michael C. Wolff Ph.D., CADC Assistant Clinical Professor, Penn State Department of Psychology
Dual Diagnosis 101Meeting the Behavioral Healthcare Needs of Persons with Intellectual and Developmental Disabilities and Co-occurring psychiatric Diagnoses (IDD/MI)
Michael C. Wolff Ph.D., CADC
Assistant Clinical Professor, Penn State Department of Psychology
Assistant Director, Penn State Psychological Clinic
Person experiencing a panic attack
Hypervigilance, obsessions, and compulsions can look like non-compliance
Can appear reckless
Video clip (16.45)
Social inhibition, feelings of
to negative evaluation
Disregard for and violation
Of the rights of others
Distrust and suspicious
Instability of interpersonal
relationships, self image, and
affect, and marked impulsivity
Detachment from social
relationships and restricted
range of emotional expression
Excessive need to be taken
care of, submissive behavior,
and fears of separation
Excessive emotionally and
Lack of capacity for close
and eccentric behavior
Preoccupation with order,
perfection, and control
Grandiosity, need for admiration
and lack of empathy
Access to health care
Quality of schools
Why does the individual behave this way?
Video 55 sec
We tend to do better when:
We tend to do worse when:
Video (Van: 6min)
Burnout and exhaustion
Feelings of inadequacy
sense of importance
(depression, loss of energy
Inability to “let go”
REGARDLESS WHATYOU CALL IT, IT CAN LEAD TO….
encroaching on personal time
Interventions: Part 2 known to have negative impact on process and outcome of interactions
Consists of three parts
Negative and harmful
Well intentioned but unhelpful
Disagreeing with client
Offering alternative suggestions
Wanting so much for the client to see the errors of their way, or the RIGHT way.
I don’t want to be this way. It used to be better. I know I can do this but it’s too damn hard. Some things help, but not enough.
I can’t cope. You don’t understand me. There is nothing else I can do. Nobody is listening to me.
I don’t need to be in counseling. It won’t help me anyway. I tried it before and was always let down. I can’t work if I am in counseling. I have too many other things going on.
It does feel good to talk to someone. There was one therapist who helped me. If I had the time, I would go back to group as well.
I don’t like my day programming, I don’t like working anymore, you can’t make me do things I don’t want to do
I do like to spend time with my friends, I do like making a little money, I just want to be able to make decisions for myself
He is the only one who understands me. I can’t live without him. We must be together. He is mean, but nobody else understands him. I can’t leave him.
I know it is not healthy, but I keep going back. Many of my needs are not being met, but he needs me. I have thought about leaving, I just don’t know where I would go.
I guess there was some good information. At least Dr. without him. McGonigle was helpful. I really could try and implement some of this information in my work.
Ok, that Mike Wolff guy was pretty boring. His 3 hour talk was about 2.5 hours too long. I could have been getting paperwork done during this time.
One final example of ambivalence