CPI Brings Best Practices to NYS

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25 Νοε 2013 (πριν από 3 χρόνια και 7 μήνες)

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CPI Brings Best Practices to NYS

Focus on Integrated Treatment for
Co
-
Occurring Disorders (FIT)


Nancy Covell, Ph.D.

Paul Margolies, Ph.D.

Forrest Foster, MSW


Center for Practice Innovations

at Columbia Psychiatry


September 15, 2011

Agenda


Review of participants’ interests and
experiences


Questions for participants


Integrated treatment


what is it and why
is it important?


CPI’s efforts to bring theses services to
consumers in NYS


How can you find out if these services are
being provided by an agency/program?

Question

True or False:


It is important to get a substance use
problem under control before dealing with
mental health issues.

Answer

False


Mueser, Noordsy, Drake & Fox (2003)

Question

For individuals who have been diagnosed
with both a serious mental illness and a
substance use problem


is it best to
receive treatment for substance use from
agencies that offer only substance use
treatment so that they can fully
concentrate on this issue?


Answer

No



Drake, RE, Essock, SM, et al. (2001).
Psychiatric Services, 52
, 469
-
476.

Question

Traditionally, have people who have been
diagnosed with both a serious mental
illness and a substance use problem been
able to receive treatment for both issues
simultaneously at either mental health or
substance use treatment programs?

Answer

No



Mueser, Noordsy, Drake & Fox (2003)




Question

True or False:


Group treatment for co
-
occurring disorders
has not been found to be helpful.

Answer

False


Mueser, Noordsy, Drake & Fox (2003)





Question

True or False:


Practitioners can’t really help to motivate
someone with co
-
occurring disorders.
Motivation is the person’s responsibility.

Answer

False


Mueser, Noordsy, Drake & Fox (2003)




Integrated treatment



what is it and why is it important?


What is integrated treatment for people
with co
-
occurring mental health and
substance use disorders (COD)?

Both mental health and substance
use treatment provided by the same
clinician or team.

No Wrong Door

Receive treatment whether you
walk into an OMH
-
licensed or
OASAS
-
certified program.



Assertive outreach and engagement


Screening and assessment


Motivational interventions


Education about mental health and substance use


Counseling


group, individual and/or family


Staged interventions to target an individual’s stage
of readiness for change


Linkage to 12
-
step programs


Long
-
term and comprehensive perspective


Culturally sensitive

Drake, RE, Essock, SM, et al. (2001).
Psychiatric Services, 52
, 469
-
476.

What does integrated treatment

for COD include?

Majority achieve abstinence or lessen
substance use substantially.

Most experience improvements in:


independent living


control of symptoms


competitive employment


social contacts with people who don’t use
substances


overall life satisfaction

Drake RE, Mueser KT, Brunette MF, et al.
(2004). A review of treatments for people with severe mental illnesses and
co
-
occurring substance use disorders.
Psychiatric Rehabilitation Journal
, 27, 360

374.

Essock SM, Mueser KT, Drake RE, et al.
(2006). Comparison of ACT and standard case management for delivering
integrated treatment for co
-
occurring disorders.
Psychiatric Services,
57, 185
-
196.

Integrated Treatment for COD is Effective!


During 1 week of 2003, in NYS:


OMH programs:
~

18% COD


OASAS programs:
~

30% COD



Conservative estimate because in our
programs, recording more than one diagnosis is
not required and is not usually done. Thus,
many people who present with both issues do
not receive diagnoses that reflect this reality.



The number of New Yorkers who can
benefit from treatment for COD is huge!


Why is treatment for COD important?

CPI’s efforts to bring theses
services to consumers in NYS

Focus on Integrated Treatment

Funded Jointly by


and


What is Unique about FIT?


We offer all training

and supports online.

We are one of a few
blazing this new trail.


Advantages to Distance Learning


Practitioners do not leave the
office for extended periods to
obtain training.

Travel costs are eliminated.

No cancelled resulting in lost
resources.


Advantages to Distance Learning


Log in and complete
modules when convenient.

Re
-
review modules
any time.

New staff trained immediately
and consistently.


35 Modules Available

Video Skill

Demonstrations

Interactive

Exercises

Recovery

Stories



Modules Address Core Competencies
of Integrated Treatment

Stage
-
wise

Treatment

Cognitive
-

behavioral

therapy

Motivational
Interviewing

Screening &

Assessment

Individual collaborative
treatment

Peer recovery

supports

Supervision

Capability & Fidelity

Leadership


What learners are saying


“I love the trainings. They are so welcome
because it is difficult to get out of the office. I
enjoy learning more about substance abuse
and value the melding of the two disciplines.”


“Very clear, effective presentation
of different types of supervision.”

“I like the mix of video and text. The information
about stages of treatment and stages of change
gives one some very concrete information which I
can directly utilize when working with an
individual”



What learners are saying


“I like the way you showed a real person in a real
situation. It made it easy to identify with the person
and view their needs as able to be met in
manageable steps ... the steps of each module were
broken down to make them easy to learn,
manageable and much in the same way I would hope
I treat my clients.”


“This module addresses the critical issue of what
leadership should look like, and what a leader
should be doing. The sections about supervision
were excellent
.



“It reinforced my beliefs about what my agency needs to
do to move our integrated program forward.”



Award
-
Winning

Brandon Hall Gold, Communicator, and 2 Silver Omni Intermedia

Module Demonstration

(10
-
15 minutes)

Supports for Implementation

Distance Implementation Supports

Monthly
Online
Discussions
and Calls


Practice
Improvement
Networks

Developing
Supervisor
Skills

Reach of FIT as of
July 31,
2011


503 programs actively participating in FIT


Programs include mental health
-
licensed
and addictions treatment
-
certified
facilities across a variety of delivery
settings (e.g., inpatient, outpatient,
residential)


5,570 individuals from those programs
registered in the learning community


0
2000
4000
6000
8000
10000
12000
14000
Nov.
09
Jan.
10
Apr.
10
Jul.
10
Oct.
10
Jan.
11
Apr
11
Jul
11
Completed (n=12,699)
Cumulative Number of FIT Modules


ALL Programs

For more information, visit our Website
http://practiceinnovations.org/


How can you find out if these
services are being provided by
an agency/program?


Ask the agency/program:



What percentage of consumers in your
program have mental health and substance
use problems?


Do you offer integrated treatment for mental
health and substance use problems?


Do these services take into account the
individual’s stage of readiness for change?
How?


Do you offer groups specifically designed for
co
-
occurring disorders? What is their focus?

Ask the agency/program:


Do you offer access to 12
-
step programs?


How many of your staff members provide this
kind of treatment?


How have your staff been trained to provide
this kind of treatment?




Questions and Answers