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Case Consult Program. Cummins Behavioral Health Systems August 2013 Doris Ryan, Ph.D., HSPP. Purpose of Program. Review treatment for cases with high usage of services Examine what’s going on when there are many crisis calls, hospitalizations, and/or a large number of services

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case consult program

Case Consult Program

Cummins Behavioral Health Systems

August 2013

Doris Ryan, Ph.D., HSPP

purpose of program
Purpose of Program

Review treatment for cases with high usage of services

Examine what’s going on when there are many crisis calls, hospitalizations, and/or a large number of services

Create an additional way for treatment teams to get assistance in difficult situations

more purposes
More Purposes

Provides treatment for the treatment team – how are we getting stuck?

An outgrowth of the “consultation team” concept in DBT

typical cases
Typical Cases

Used this with about 10 cases in the last year

Consumers about evenly divided between male and female

From 4 different offices

Ranging in age from 20 to 50

Common denominator: personality issues

common patterns
Common Patterns
  • Personality issues plus:
    • Substance abuse
    • Serious health problems
    • Lack of family stability and support
    • Intermittent psychosis
    • Lots of complexity!
consultation process
Consultation Process
  • Starts with a call from the treatment team
  • First step is a chart review by the consultant
  • Second step is a meeting of team with consultant to clarify information – consumer not present
  • Then some options:
    • Make recommendations to team, check back later with them
    • Meet regularly, weekly at first, to coach
    • Provide training to team members
team issues to address
Team Issues to Address
  • What outcome fits with consumer needs and abilities?
    • Cure
    • Amelioration of the consumer’s problems
    • Improvement inone problem
    • Behavioral management of the problems
    • Referral to more appropriate services

(from Greg Lester, “Personality Disorders in Social Work and Health Care”)

more team issues
…. More Team Issues

Recognizing drama versus talk and its relation to treatability

Dealing with the team’s motivation to treat more

Addressing the current“stage of change”

Creating a common basis of knowledge in the team

Addressing team’s information and skill needs

Getting realistic about how long change takes

success means roadblocks were resolved
Success Means Roadblocks Were Resolved
  • Some of the outcomes:
    • Ongoing consultation teams for two consumers – crisis calls and hospitalizations reduced
    • Re-involved one consumer in his treatment after a substance abuse relapse
    • One consumer and family started working harder in treatment because of the team interest
    • Arrangement of more appropriate treatment when needed