Dual Diagnosis: Assessment and Treatment
|
|
- Kory Knight
- 6 years ago
- Views:
Transcription
1 Dual Diagnosis: Assessment and Treatment Kris4ne strauss, psyd, cadc
2 GIFT CARD DRAWING! LIKE the Illinois Forensic Associates page on Facebook by December 15 th for a $10 gift card!
3 Definitions/Terminology
4 Defini4ons/ Terminology Any Mental Illness (AMI): adults aged 18 or older: the presence of any mental, behavioral, or emotional disorder in the past year that met DSM criteria (not including substance use disorders) Nationally, 43.4 million adults aged 18 or older experienced AMI in the past year, corresponding to a rate of 18.2 percent, Illinois 15.86% (SAMHSA, 2014/ NIMH, 2015) Serious Mental Illness (SMI): a disorder which caused substantial functional impairment (i.e., a disorder that substantially interfered with or limited one or more major life activities) and has an urgent need for treatment (not including developmental and substance use disorders) Among adults aged 18 or older, the national rate of SMI is 9.8 million Americans which equates to 4.0 percent, Illinois 3.21% (SAMHSA, 2014/ NIMH, 2015)
5 Dual Diagnosis Both diagnosable mental illness and substance use Ø (DSM 5: Use Disorder, mild, moderate, severe); co-occurring Each can be mild or severe with one being more severe than other; each can vacillate over 4me Substance use can be e4ology of MI symptoms; or MI to substance use Substance use worsens symptoms of MI Symptoms of substance use can mimic symptoms of mental illness, and symptoms of mental illness can be confused with symptoms of substance use
6 American Society of Addic4on Medicine (ASAM) Mentally Ill Chemically Addicted (MICA) Chemical Abuse and Mental Illness (CAMI) Mental Illness Substance Abuse (MISA) Substance Abuse and Mental Illness (SAMI) Individuals with Co-Occurring Psychiatric and Substance Symptomology (ICOPSS) Dual Disorders, Dual Diagnosis, Coexis4ng, Co- Morbid, Co-Occuirng, Mul4ple Vulnerabili4es (2005)
7 Statistics
8 According to Substance Abuse and Mental Health Services Administra4on, 7.9 million persons have co-occurring disorders (SAMHSA, 2014) 25.7% of all adults with SMI diagnosed with substance dependence (Na4onal Survey on Drug Use and Health, 2009) 7.4% of individuals receive treatment for both condi4ons 55.8% percent receive NO treatment at all (SAMHSA, 2009) 68% of adults with mental disorder also had one or more medical condi4ons (Na4onal Co-Morbidity Survey Replica4on) 70-90% of offenders use illicit drugs during their life4me; 50-80% we under influence at?me of arrest; 50-70% of those have life?me dx of abuse or dependence (Tafrate & Mitchell, 2014) 75% of jail inmates with a mental health diagnosis have a co-occurring substance use disorder (SAMHSA, 2009)
9 Bureau of Justice (2006) Jail Inmates State Prisoners Mental health problem (defined as recent hx (clinical dx or tx)or sx occurred within last 12 months) with current or past violent offense 44% 61% Mental health problem and also met criteria for substance dependence or abuse 76% 74% Mental health problem and were dependent on or abused drugs Mental health problem and were dependent on or abused alcohol Mental health problem and used drugs at the time of offense No mental health problem and used drugs at the time of offense 63% 62% 51% 53% 34% 37% 20% 26%
10 Forensic
11 What is considered forensic : Professional conduct is considered forensic from the 4me the prac44oner reasonably expects to, agrees to, or is legally mandated to, provide exper4se on an explicitly psycholegal issue. psychologists are encouraged to consider the poten4al impact of the legal context on treatment, the poten4al for treatment to impact the psycholegal issues involved in the case. As advisors, forensic prac44oners may provide an aborney with an informed understanding of the role that psychology can play in the case at hand. As consultants, forensic prac44oners may explain the prac4cal implica4ons of relevant research, examina4on findings, and the opinions of other psycholegal experts. As examiners, forensic prac44oners may assess an individual s func4oning and report findings and opinions to the aborney, a legal tribunal, an employer, an insurer, or others (American Psychological Associa4on, 2010; American Psychological Associa4on, 2011a). As treatment providers, forensic prac44oners may provide therapeu4c services tailored to the issues and context of a legal proceeding. As mediators or nego?ators, forensic prac44oners may serve in a third-party neutral role and assist par4es in resolving disputes. As arbiters, special masters, or case managers with decision-making authority, forensic prac44oners may serve par4es, aborneys, and the courts (American Psychological Associa4on, 2011b).
12 Court Ordered: Substance Use Process Addic4ons Domes4c Violence Anger Management What makes a good forensic clinician? Sex Offender Fitness Evalua4ons/ Sanity Evalua4ons Restora4on to Fitness Expert Witness Individual Family: Custody Evalua4ons and Reunifica4on Ø Games Criminals Play and How You Can Profit by Knowing Them; employees/ officers = clinicians; applicable to tx. Ø Firm, fair and consistent (Allen & Bosta, 1981) Ø meet an emergency with cool headed composure (Allen & Bosta, 1981) Ø Talents, Traits, Abili4es and Strengths: Produc4vely Mellow Perceived as professional (Allen & Bosta, 1981)
13
14 What s the difference?! (Forensic vs. General/Regular ) Results determine convic4on and/or sentence Manipula4on strong for personal gains (also in non-judicial but more mo4va4on to be perceived in favorable light i.e. freedom); face value Client s percep4on at onset of assessment/treatment Limits of confiden4ality: court, lawyer, parole, proba4on Ø Always state all par4es involved must have release of info at onset of tx., no choosing to use or not based on dx Life4me court record Ø Adverse life events that may impact behavior Compliance results in successful comple4on of sentence or nolle pros
15 Screenings
16 Screening ASAM u4liza4on of screening tools = preven4on of, or early interven4on, in addic4on Ø Iden4fica4on of early warning signs can be enough to change nega4ve drinking or drug use habits SAMSHA endorsed screening approach = Integrated Screening, Brief Interven4on and Referral to Treatment (SBIRT): Ø Brief process to determine if likely a substance use disorder and at least one cooccurring mental disorder Ø Screening should quickly assesses severity of substance use and iden4fy appropriate level of treatment Ø Having an individual respond to a specific set of ques4ons and scoring those ques4ons Ø Brief interven4on should focus on increasing insight and awareness regarding substance use and mo4va4on toward behavioral change Ø Individuals who screen posi4ve may receive a detailed, integrated assessment of current and historical symptoms/behaviors
17 Screening, Cont d. Examples of screening tools: Ø CAGE Adapted to Include Drugs (CAGE-AID) Ø Simple Screening Instrument for Alcohol and Other Drugs (SSI-AOD) Ø Lie/Bet Ques4onnaire Ø Mental Health Screening Form III (MHSF-III) Ø Modified Mini Screen (MMS) Ø Michigan Alcohol Screening Test (MAST) Ø Drug Abuse Screening Test (DAST) Ø Texas Chris4an University Drug Screen; Center for Epidemiologic Studies Depression Scale (CES-D Scale) Ø Social Interac4on Anxiety Scale (SIAS) Ø PTSD Checklist (PCL) These measures are commonly used, public domain screening tools Cover a broad, inclusive range of psychiatric and substance use disorders; self report S4ll may require review/follow-up with clients responses especially forensic popula4on
18 Current risk of harm to self or others in both screening and assessment Screening à iden4fy possible presence of a problem vs. Assessment à define the problem and result in specific treatment recommenda4ons Ø Detailed chronological history of past symptoms, previous diagnosis, treatment, and impairment; 4meline of symptom expression and correla4ng substance use
19 Assessment
20 Assessment Conduct an assessment with Biological/ Psychological/Social e4ology approach for both MI and Substance Use Determine level of severity of each diagnosis Determine which has the most important treatment priority Iden4fy strengths and supports
21 Assessment Cont d. Use objec4ve assessments (qualified clinicians) to assist in diagnosis and severity Ø Mini Mental Status Exam (MMSE) Ø Cogni4ve Capacity Screening Exam (CCSE) Ø Beck Depression Inventory-II (BDI-II) Ø Beck Anxiety Inventory (BAI) Ø Addi4onal psychological babery Ø Support by subjec4ve assessments (qualified clinicians)
22 Assessment Cont d. According to ASAM (2005), mul4dimensional assessment should include: Acute Intoxica?on/ Withdrawal Poten?al: Past history of serious, lifethreatening withdrawal/currently having similar withdrawal symptoms Biomedical Condi?ons and Complica?ons: Any current severe health problems Emo?onal/Behavioral/Cogni?ve Condi?ons: Assess any immediate needs such as Imminent danger of harm to self/others, unable to carry/meet ADL s imminent danger to self or others Readiness to Change: Thoughts/feelings towards treatment - treatment coerced, mandated Relapse/Con?nued Use/Con?nued Problem Poten?al: Currently under the influence, con4nued use/problems imminently dangerous Recovery Environment: Immediate threats to safety, well-being, and/or sobriety
23 Dis4nguishing Diagnos4c History
24 Case of Mr. G 45 year old, married, Caucasian male Presented to ED aqer wife called 911 as a result of pa4ent punching in the door in when he couldn t open it. Pt. reported being able to sing and dance in the clouds and in moving traffic. Pt. reported impulsive behaviors, such as drove to New York (from RI) and bought a cow for fresh milk everyday. Pt. presented with pressured speech, tangen4al thought process, elevated mood Pt. endorsed current inability to sleep Pt. endorsed previous periods of fa4gue, sleeping a lot, periods of increased appe4te and being sad Family reported hx of pt. having comba4ve, aggressive episodes
25 Clinical Interviewing Skills
26 Case of Mr. Johnson
27 Malingering
28 Malingering Z76.5 The essen4al feature of malingering is the inten4onal produc4on of false or grossly exaggerated physical or psychological symptoms, mo4vated by external incen4ves such as avoiding military duty, avoiding work, obtaining financial compensa4on, evading criminal prosecu4on or obtaining drugs. Under some circumstances, malingering may represent adap4ve behavior-for example, feigning illness while a cap4ve of the enemy during war4me. Malingering should be strongly suspected if any combina4on of the following is noted: 1. Medicolegal context for presenta4on (e.g., the individual is referred by an aborney to the clinician for examina4on or the individual self refers while li4ga4on or criminal charges are pending). 2. Marked discrepancy between the individual s claimed stress or disability and the objec4ve findings and observa4ons. 3. Lack of coopera4on during the diagnos4c evalua4on and in complying with the prescribed treatment regimen. 4. The presence of an4social personality disorder. Malingering vs. Conversion Disorder vs. Fac44ous Disorder
29 The primary focus of the SIRS-2 is to assess deliberate distor4ons, fabrica4ons or exaggera4on of self reported symptoms
30 1. Rare Symptoms: Are you bothered by strange smells wherever you go? 2. Symptom Combina4ons: Do you have a need to wash your hands frequently? Is it related to any unique or special powers? 3. Improbable or Absurd Symptoms: Do you have unusual beliefs about automobiles? Do you believe they have their own religion? 4. Blatant Symptoms: Do you have any major problems with figh4ng evil forces? 5. Subtle Symptoms: Do you have any major problems with waking up early in the morning? 6. Severity of Symptoms; unbearable 7. Selec4vity of Symptoms; random in endorsement 8. Reported vs. Observed Symptoms
31 The Test of Memory Malingering is a visual recogni4on test designed to help psychologists and psychiatrists dis4nguish between malingered and true memory impairments. TOMM is sensi4ve to malingering and insensi4ve to a wide variety of neurological impairments, which makes it very reliable
32 Minnesota Mul4phasic Personality Inventory-2 MMPI-2 most widely used and widely researched personality assessment; 567 items are designed to evaluate thoughts, emo4ons, axtudes, and behavioral traits that comprise personality
33 Reports
34 Report Wri4ng Language used Ø Reported Ø Stated Ø Clinical assessment resulted in a diagnosis of Ø Record review indicated Ø Clinical judgement Ø With a reasonable degree of clinical certainty Subjec4ve vs. objec4ve assessments Jus4fy Remember will be court record ; APA Ethics for Forensic Psychologist
35 Treatment
36 Treatment Overview Goal: return to healthy, produc4ve func4oning in family, work and community Least restric4ve level of care (ASAM); evidence based approaches No singular treatment is appropriate for everyone Ø Based on drug of choice Ø Baseline func4oning: cogni4ve, behavioral, medical (including pregnancy) Ø History of use/treatment abempts Ø Consider age, gender, trauma history, current legal status At least 3 months to significantly reduce or stop substance use; best outcomes with longer dura4ons (Na4onal Ins4tute on Drug Abuse (NIDA), 2012)
37 Treatment Cont d. Detox does not address psychological, social, behavioral problems; does not typically produce long term recovery (NIDA, 2012) Level of care may need to be adjusted to meet needs as more informa4on is disclosed/uncovered/changes Medica4ons may be u4lized as an effec4ve component of treatment when in conjunc>on with behavioral treatment programs (NIDA, 2012) Ø Opioids Ø Alcohol Ø Benzodiazepines Ø Barbiturates Ø Nico4ne Ø Psychotropic medica4ons
38 Treatment Cont d. Concurrently treat the individual biologically, psychologically and socially; integrated treatment Integra4ve treatment most effec4ve à treated at the same 4me, in the same place, by the same treatment team (Hazeldon, 2014) Integra4ve treatment produces beter outcomes for individuals with co-occurring mental and substance use disorders (SAMHSA, 2014) Individualized treatment planning unique to the offender (U. of N. M., 2011) Aqercare (community based) (U. of N. M., 2011)
39 Impediments to Integra4ve Treatment Thorough assessment for appropriateness for level of care/program State and Federal funding limitations Insurance approval Limited dual diagnosis centers/ Limited beds Criminal justice system Ø While incarcerated, limited jail based tx. offered/provided Ø If/when treatment approved by courts, co-occurring disorder must be stabilized prior to transfer which can be difficult with limited formulary medication Ø Shorter jail episodes (U. of N.M., 2011) Agencies collaborating effectively for continuity of care Compliance (to all integrative tx. recommendations) Resistance
40 Treatment Cont d. Success not solely determined by voluntary incep4on; mandated treatment have demonstrated as favorable outcomes as voluntarily onset (NIDA, 2012) Illinois Department of Human Services; Division of Alcoholism and Substance Abuse (DASA) independent evalua4on : reported use of alcohol decreased from 59% at admission to 30% six months post treatment; marijuana from 30% to 6%; cocaine from 37% to 6 %; heroin from 24% to 6 % (DASA, 2015) Treatment success rate for reducing drug use is 40-60%; comparable to success rates for asthma and hypertension (DASA, 2015)
41 Evidence Based Therapies Cogni4ve Behavioral Therapy Ø Iden4fy and correct problema4c, maladap4ve behaviors Ø T-F-B Ø Development of coping skills Ø Alcohol, Marijuana, Cocaine, Methamphetamine and Nico4ne (NIDA, 2012) Con4ngency Management Interven4ons/Mo4va4onal Incen4ves Ø Giving tangible rewards to reinforce desirable behavior Ø Incen4ve based interven4ons can be effec4ve in treatment reten4on and abs4nence Ø Voucher Based Reinforcement (VBR) Ø Cau4onary for co-morbid gambling Ø Alcohol, S4mulants, Opioids, Marijuana, Nico4ne (NIDA, 2012)
42 Evidence Based Therapies, Cont d. Community Reinforcement Approach Plus Vouchers Ø Intensive 24 week outpa4ent treatment Ø Counseling focused on improving family rela4ons, skills to minimize drug use, voca4onal counseling, aid in development of new recrea4onal ac4vi4es and social supports Ø Antabuse Ø Clean urinalysis (cocaine) receive vouchers Ø Alcohol, Cocaine, Opioids (NIDA, 2012) Mo4va4onal Enhancement Therapy Ø Counseling approach to resolve ambivalence about involvement in treatment and ceasing drug use (NIDA, 2012) Ø Assessment, feedback session, 2-4 individual sessions Ø Goal to stop use and facilitate treatment entry Ø Mo4va4onal interviewing principles and development of coping skills Ø Alcohol, Marijuana, Nico4ne (NIDA, 2012)
43 Evidence Based Therapies, Cont d. The Matrix Model Ø Receive direc4on, support educa4on regarding self help groups from therapist teacher and coach fostering a posi4ve encouraging rela4onship to reinforce posi4ve behavior change (NIDA, 2012) Ø U4lize detailed treatment manuals Ø Monitored by urinalysis Ø S4mulants (NIDA, 2012) Family Behavior Therapy Ø Address substance use with at least one significant other Ø Aim to improve home environment Ø Rewards provided by significant other when behavior goals are met Ø Especially beneficial for youth popula4on
44 Treatment, Cont d. Dual Diagnosis Capable (DDC) vs. Addic4on Only Services (AOS), (ASAM, 2011) Ø DDC accept co-occurring disorders Ø MI generally stable Ø Independent func4oning so MI does not interfere with addic4on treatment Ø Collabora4on with mental health assessment and treatment Ø Psychotropic medica4on monitoring Ø Integrated treatment and discharge planning Dual Diagnosis Enhanced (DDE) Ø More intense supervision/stabiliza4on needed Ø Not as unstable as current harm to self or others or one on one/24 watch Ø Integrated discharge planning
45 Specialized Assessment/Treatment
46 Specialized Assessment/Treatment Psychosexual Risk Evalua4on, Sex Offender Specific Treatment Domes4c Violence Treatment; Risk evalua4on prior to convic4on/sentence Fitness Evalua4ons; Restora4on to Fitness Treatment Insanity Evalua4ons Moral Recona4on Therapy (MRT); Cogni4ve Behavioral Treatment System Ø Prevent recidivism, ins4ll more posi4ve iden4ty, change poor decision making and behavior paberns into more posi4ve pro-social, honest, goal oriented direc4ons & ready clients for work/school/volunteer (Correc4onal Counseling, 2015) Addicted Offenders : CBT, REBT (Tafrate & Mitchell, 2014) Substance Abusing Judicial Clients : Social and Community Responsibility Therapy (SCRT), (Tafrate & Mitchell, 2014)
47 Specialty/Problem Solving Courts
48 Specialty/Problem Solving Courts Nexus needed; may require specialized screenings, assessments and/or treatments Ø All have clinical/diagnos4c criteria along with legal Ø Consider court requirements of repor4ng Drug Court Mental Health Court Veterans Court Adult Redeploy Court
49 References 1. Bureau of Jus4ce: Mental Health Problems of Prison and Jail Inmates (2006) 2. Specialty Guidelines for Forensic Psychology. American Psychological Associa4on (2016) 3. Allen & Bosta (1981) Games Criminals Play: How You Can Profit by Knowing Them. Sacramento, CA: Rae John Publishers 4. Tafrate & Mitchell (2014) Forensic CBT: A Handbook for Clinical Prac>ce. West Sussex, UK: Wiley Blackwell 5. Combined 2011 and 2012 Na4onal Surveys on Drug Use and Health 6. Co-Morbidity of Medical: Na4onal Comorbidity Survey Replica4on (NCS-R) 7. Department of Jus4ce s Survey of Inmates in State and Federal Correc4onal Facili4es (2004) 8. Hazeldon (2014) 9. Na4onal Survey on Drug Use and Health (2009) 10. Na4onal Ins4tute on Drug Abuse. (2012). Principles of Drug Addic4on Treatment. 11. Substance Abuse and Mental Health Services Administra4on (2009), (2014) 12. Survey of Inmates in Local Jails (2002) 13. The University of New Mexico: Ins4tute for Social Research (2011). Jail Based Substance Abuse Treatment Literature Review 14. Correc4onal Counseling: Cogni4ve Behavioral Treatment Review (24) 15. American Society of Addic4on Medicine Retrieved from:
Dual Diagnosis: Assessment and Treatment in Forensic Popula7ons
Dual Diagnosis: Assessment and Treatment in Forensic Popula7ons Kris7ne strauss, psyd, cadc ks@ifassociates.org www.ifassociates.org GAS CARD DRAWING! LIKE the Illinois Forensic Associates page on Facebook
More information10/26/15. Perspec'ves on maternal opioid use and abuse. Dr. Rita J. Nutt. Our Expectation. Harsh Realities
10/26/15 Perspec'ves on maternal opioid use and abuse Dr. Rita J. Nutt Our Expectation Harsh Realities 1 Opioid Abuse and Dependence Statistics, 2013 4.5 million people in the US current non- medical users
More informationMedica8on Assisted Treatment (MAT) in Jails and Community- Based SeDngs
Medica8on Assisted Treatment (MAT) in Jails and Community- Based SeDngs Lisa Ramirez, Lead Program Specialist, Texas Department of State Health Services, Mental Health and Substance Abuse Division Rebecca
More informationAre We Ready for ASAM? Does the ASAM Level of Care Designa:ons Correspond to Clinical Judgment?
Are We Ready for ASAM? Does the ASAM Level of Care Designa:ons Correspond to Clinical Judgment? Desirée A. Crevecoeur-MacPhail, PhD UCLA Integrated Substance Abuse Programs Semel Ins@tute for Neuroscience
More informationASAM CRITERIA 3 rd Edition
ASAM CRITERIA 3 rd Edition Presented by Mark Disselkoen, LCSW, LADC CASAT Based on DSM 5 & The ASAM Criteria Manual The ATTC Network Ten Regional Centers Central Rockies ATTC is now the Mountain Plains
More informationViolence, Drugs and Health: Implica8ons for a Trauma-Informed Approach in a Healthcare Se>ng
Violence, Drugs and Health: Implica8ons for a Trauma-Informed Approach in a Healthcare Se>ng Terri L. Weaver, Ph.D. Saint Louis University Department of Psychology Saint Louis, Missouri Trauma'c Stress
More informationDUI SERVICE PROVIDER ORIENTATION DAY 2 AFTERNOON: DUI ASSESSMENT TOOLS
DUI SERVICE PROVIDER ORIENTATION DAY 2 AFTERNOON: DUI ASSESSMENT TOOLS 2017-2018 IDHS DUI ORIENTATION ASSESSMENT TOOLS My Training Room Rules richard.krajewski@dupageco.org updated 10/2017 Assessment Tools
More informationDUI SERVICE PROVIDER ORIENTATION
DUI SERVICE PROVIDER ORIENTATION Illinois Department of Human Services Division of Alcoholism and Substance Abuse Provided by the Institute for Legal, Legislative & Policy Studies Center for State Policy
More informationChapter 7. Screening and Assessment
Chapter 7 Screening and Assessment Screening And Assessment Starting the dialogue and begin relationship Each are sizing each other up Information gathering Listening to their story Asking the questions
More informationImproving Outcomes for Justice-Involved Individuals with Mental Health and Substance Use Disorders
Improving Outcomes for Justice-Involved Individuals with Mental Health and Substance Use Disorders Bree Derrick, Senior Policy Analyst May 2014! Organiza4on and Funders Council of State Governments: National
More informationPsychological Testing in the Forensic Setting
Psychological Testing in the Forensic Setting Dr. Blair M. Brown Licensed Clinical Psychologist October 2018 Thank you. 1 Expectations for Today Expect: An overview of the different tests used and what
More informationSentencing and Justice Reinvestment Initiative
Sentencing and Justice Reinvestment Initiative February 13, 2014 Michigan Law Revision Commission Carl Reynolds, Senior Legal & Policy Advisor Shane Correia, Program Associate Council of State Governments
More informationServing consumers with criminal jus4ce involvement: Current status of CIT, BLET, CJ LEADS and other ini4a4ves
Serving consumers with criminal jus4ce involvement: Current status of CIT, BLET, CJ LEADS and other ini4a4ves A presenta4on to the Alamance Stepping Up Task Force Alamance Regional Medical Center, Burlington,
More informationLAI: Linee guida ed esperienze internazionali
LAI: Linee guida ed esperienze internazionali LAI: Guidelines and interna5onal experience PM Llorca CHU Clermont-Ferrand EA 7280 Université Clermont Auvergne Disclosures Advisory board: Allergan, Jansen,
More informationPharmacology of Addic0ve Disorders
Pharmacology of Addic0ve Disorders Thomas Kosten MD JH Waggoner Chair & Professor of Psychiatry, Pharmacology, Immunology, Pathology, Neuroscience & Epidemiology Baylor College of Medicine & MD Anderson
More informationDid Great Explorers Have ADHD? 8/5/17. A(en+on Deficit Hyperac+vity Disorder in Adults. Did Great Ancient Hunters Have ADHD?
A(en+on Deficit Hyperac+vity Disorder in Adults Understanding, Evalua+ng and Managing a Life+me Condi+on Sam Goldstein Ph.D. University of Utah Neurology, Learning and Behavior Center www.samgoldstein.com
More informationSexually Addicted Offender Program
1000 Germantown Pike F-5 Plymouth Meeting, PA 19462 610-844-7180 drjenniferweeks@gmail.com Sexually Addicted Offender Program The Sexually Addicted Offender program at SATS is based on the Risk Needs Responsivity
More informationCLIENT HISTORY CLIENT LEGAL NAME: CLIENT PREFERRED NAME:
CLIENT HISTORY CLIENT LEGAL NAME: DATE: CLIENT PREFERRED NAME: FAMILY & SOCIAL BACKGROUND Please list and describe your current family members (immediate, extended, adopted, etc.) and/or other members
More informationRonette Goodwin, Ph.D. Forensic and Psychological Experts, Inc Crenshaw Blvd. #179 Torrance, CA (866)
Ronette Goodwin, Ph.D. Forensic and Psychological Experts, Inc. 2390 Crenshaw Blvd. #179 Torrance, CA. 90501 (866) 853-0056 goodwindoc@aol.com ACADEMIC BACKGROUND August 2001 Harbor UCLA Medical Center,
More informationRecrea&onal Therapy. Thomas K. Skalko, Ph.D., LRT/CTRS Chair, Commi<ee on Accredita&on of Recrea&onal Therapy Educa&on
Recrea&onal Therapy Thomas K. Skalko, Ph.D., LRT/CTRS Chair, Commi
More informationCommon Data Elements: Making the Mass of NIH Measures More Useful
Common Data Elements WG Common Data Elements: Making the Mass of NIH Measures More Useful Jerry Sheehan Assistant Director for Policy Development Na?onal Library of Medicine Gene/c Alliance Webinar Series
More informationSteven E. Bruce, Ph.D. PTSD Preven2on and Treatment
Steven E. Bruce, Ph.D. PTSD Preven2on and Treatment Center for Trauma Recovery University of Missouri-St. Louis Washington University School of Medicine Prevalence of Trauma and PTSD 70-90% of
More informationPerspec'vas Psicologicas en el Cuidado de la Diabetes
Perspec'vas Psicologicas en el Cuidado de la Diabetes Antonio E. Puente University of North Carolina Wilmington Universidad de la Ciudad de Juarez 09.20.13 Health Sta's'cs: 2010 (The Economist, 12.12.09)
More informationMental Health, Substance Abuse & Primary Care: Bridging Gaps in Access
1 Mental Health, Substance Abuse & Primary Care: Bridging Gaps in Access Christopher Carroll, Director, Health Care Financing and Systems Integration Substance Abuse and Mental Health Services Administration
More informationNote: The trainings below represent a foundational list, and may be adapted based on audience and need.
MOTIVATIONAL INTERVIEWING Introduction to Motivational Interviewing (offered in English and Spanish) 2-day Course (12-14 credit hours) This course is designed to introduce clinicians and staff members
More informationClinical Staging and the At-Risk Phase of Psychotic Disorder
Clinical Staging and the At-Risk Phase of Psychotic Disorder Sabina Abidi MD FRCPC IWK Youth Psychosis Program Capital Health Nova ScoCa Early Psychosis Program Key Findings in Early Psychosis Knowledge
More informationPRINCE GEORGES COUNTY VETERANS TREATMENT COURT
PRINCE GEORGES COUNTY VETERANS TREATMENT COURT Ten Key Components of Veterans Treatment Court Integrate alcohol, drug treatment, mental health treatment, medical services with justice system case processing.
More informationPreven+ng Carpal Tunnel & Other Work Related Injuries
Objec+ves At the end of this session, par+cipants will be able to: Preven+ng Carpal Tunnel & Other Work Related Injuries Anne M. Haskins, PhD, OTR/L Department of Occupa+onal Therapy 1. Iden+fy physical
More informationSpo$ng and Managing Delayed Recovery in Injured Workers
Disclosure Informa5on Western Occupa5onal Health Conference 2011 I have the following financial rela5onships to disclose: I have nothing to disclose - and- I will not discuss off label use and/or inves5ga5onal
More informationUpper Extremity Fractures and Secondary Fall Prevention: Opportunities to Improve Management and Outcomes Across Disciplines.
Upper Extremity Fractures and Secondary Fall Prevention: Opportunities to Improve Management and Outcomes Across Disciplines Chris,ne McDonough, PhD, PT, CEEAA Health Outcomes Unit Department of Health
More informationPsychological (Emotional/Mental) Disorders. Mental disorder. Your turn 11/30/11
Psychological (Emotional/Mental) Disorders Mental disorder Any ongoing behavior or psychological emo3onal state that causes a person to suffer, is self- destruc3ve; seriously impairs the person s ability
More informationScreening Tools and Testing Instruments
Screening tools are meant to initially discover a potential problem in chemical use, dependency, abuse, and addictions. They are typically done in conjunction with a more in-depth assessment. For example,
More informationChapter 7. Screening and Assessment
Chapter 7 Screening and Assessment Screening And Assessment Starting the dialogue and begin relationship Each are sizing each other up Information gathering Listening to their story Asking the questions
More informationPsychological outcomes of cri2cal illness for pa2ents and family members. Erin K. Kross, MD Summer Lung Day June 18, 2010
Psychological outcomes of cri2cal illness for pa2ents and family members Erin K. Kross, MD Summer Lung Day June 18, 2010 Outline Overview of psychological outcomes for pa2ents and family members ager cri2cal
More informationFindings from the At Home / Chez Soi Demonstration Project in Canada. Paula Goering and Catharine Hume May 2, 2013
Findings from the At Home / Chez Soi Demonstration Project in Canada Paula Goering and Catharine Hume May 2, 2013 Outline for today Overview of Project Design Na8onal level findings re one year outcomes
More informationMINOR CLIENT HISTORY
MINOR CLIENT HISTORY CLIENT NAME: DATE: FAMILY & SOCIAL BACKGROUND: Please list and describe your child s or teen s current family members (immediate, extended, adopted, etc.) NAME RELATIONSHIP AGE OCCUPATION
More informationApproaches for the Culturally-Competent Counselor to use with Offender Clients Sarah Littlebear, PhD, LPC Blue Ridge Judicial Circuit Cherokee County
Approaches for the Culturally-Competent Counselor to use with Offender Clients Sarah Littlebear, PhD, LPC Blue Ridge Judicial Circuit Cherokee County Mental Health Court The Drug Court Client What is the
More informationIntegrated Care Model for Problem Gambling
Integrated Care Model for Problem Gambling Rick McNeese, Ph.D. First Step Recovery and Wellness Center Lincoln, Nebraska The Midwest Conference on Problem Gambling and Substance Abuse Kansas City, Missouri
More informationEthics and Boundaries
Ethics and Boundaries Jim Seckman, MAC, CACII, CCS What are the defining characteris@cs of a profession? A body of knowledge A special group of skills Addresses a special problem Tes@ng for admission Lifelong
More informationASAM Criteria, Third Edition Matrix for Matching Adult Severity and Level of Function with Type and Intensity of Service
1: Acute Intoxication and/or Withdrawal Potential Risk Rating: 0 1: Acute Intoxication and/or Withdrawal Potential Risk Rating: 1 1: Acute Intoxication and/or Withdrawal Potential Risk Rating: 2 The patient
More information7/30/13. Webinar Organizer. Using GoToWebinar. Produced By. Webinar Objectives. Obtaining CE Credit
DSM- 5: Comparisons and Implications for Addiction Professionals Webinar Organizer Misti Storie, MS, NCC Presented by: Dr. Norman G. Hoffmann, Adjunct Professor of Psychology, Western Carolina University
More informationMedication-Assisted Treatment. What Is It and Why Do We Use It?
Medication-Assisted Treatment What Is It and Why Do We Use It? What is addiction, really? o The four C s of addiction: Craving. Loss of Control of amount or frequency of use. Compulsion to use. Use despite
More informationFamily & Children s Services MENTAL HEALTH SERVICES FOR ADULTS
Family & Children s Services MENTAL HEALTH SERVICES FOR ADULTS You don t have to suffer from mental illness. We re here to help you with problems that seem overwhelming and too difficult to handle alone.
More informationNote: The trainings below represent a foundational list, and may be adapted based on audience and need.
MOTIVATIONAL INTERVIEWING Introduction to Motivational Interviewing (offered in English and Spanish) 2-day Course (12-14 credit hours) This course is designed to introduce clinicians and staff members
More informationLearning Objec1ves. Study Design Considera1ons in Clinical Pharmacy
9/28/15 Study Design Considera1ons in Clinical Pharmacy Ludmila Bakhireva, MD, PhD, MPH Pree Sarangarm, PharmD, BCPS Learning Objec1ves Describe the features, advantages and disadvantages of the observa1onal
More informationKAP KEYS Based on TIP 34 Brief Interventions and Brief Therapies for Substance Abuse. Knowledge Application Program. KAP Keys.
KAP KEYS Based on TIP 34 Knowledge Application Program KAP Keys For Clinicians Based on TIP 34 Brief Interventions and Brief Therapies for Substance Abuse KAP KEYS Based on TIP 34 2 Introduction These
More informationWho is a Correctional Psychologist? Some authors make a distinction between correctional psychologist and a psychologist who works in a correctional f
Correctional Psychology Who is a Correctional Psychologist? Some authors make a distinction between correctional psychologist and a psychologist who works in a correctional facility Correctional psychologists
More informationLearning Objec1ves. Study Design Strategies. Cohort Studies 9/28/15
9/28/15 Learning Objec1ves Describe the features, advantages and disadvantages of the observa1onal study designs Explain why the overall study design is important when evalua1ng studies & applying their
More informationCan Psychotropic Medica2on ever be the Least Restric2ve Interven2on for Behaviour that Challenges?
Can Psychotropic Medica2on ever be the Least Restric2ve Interven2on for Behaviour that Challenges? Dr Juli Crocombe Consultant Psychiatrist, Director of Clinical Services and Research Overview Terminology
More informationTrauma Management Therapy for OEF and OIF Combat Veterans
Trauma Management Therapy for OEF and OIF Combat Veterans Nina Wong, M.S. Deborah C. Beidel, Ph.D., ABPP B.Christopher Frueh, Ph.D. Sandra Neer, Ph.D. Center for Trauma, Anxiety, Resilience and Prevention
More informationContents Opioid Treatment Program Core Program Standards... 2
2017 OPIOID TREATMENT PROGRAM PROGRAM DESCRIPTIONS Contents Opioid Treatment Program Core Program Standards... 2 Court Treatment (CT)... 2 Detoxification... 2 Day Treatment... 3 Health Home (HH)... 3 Integrated
More informationRecovery Education for Addictions and Complex Trauma
RULES: Thank you for your interest in RE:ACT ( ). Prior to submitting your application, we require you to read the following program policies. In order to be admitted into this program, these policies
More informationRecovery as an issue of social justice and social inclusion
Recovery as an issue of social justice and social inclusion Professor David Best Sheffield Hallam University / Monash University November 2016: Copenhagen The central values of the centre: widening access
More informationNational Findings on Mental Illness and Drug Use by Prisoners and Jail Inmates. Thursday, August 17
National Findings on Mental Illness and Drug Use by Prisoners and Jail Inmates Thursday, August 17 Welcome and Introductions Jennifer Bronson, Ph.D., Bureau of Justice Statistics Statistician Bonnie Sultan,
More informationPsychological Testing. Brenda Gomez, M.A.
Psychological Testing Brenda Gomez, M.A. Introduction Forensic Mental Health Assessment What is a FMHA? How does this differ from a regular clinical assessment? Who performs the evaluations? How do I determine
More informationMODULE 1 SBIRT: AN OVERVIEW
2 Acknowledgements MODULE 1 SBIRT: AN OVERVIEW The material included in this course is based largely on the training materials developed by Robert W. Hazlett, Ph.D., for the LA-SBIRT project of the LSU
More informationBeyond Sobriety: How To Effectively Treat Clients with Co- Occurring Disorders (COD)
Beyond Sobriety: How To Effectively Treat Clients with Co- Occurring Disorders (COD) Presenters: Christi Weaver, LCSW Stacey Lewis, LCSW Margaret Cohenour, LCSW 1 Living with COD Video: Living with COD
More informationSAMPLE. Date of Birth: Age: Gender: Woman: Man: Transgender: Transman: Transwoman: Gender Nonconforming: Other:
Patient Intake Questionnaire Note: This is a sample intake questionnaire which includes a wide variety of potential questions that can be asked of new clients during the intake process. Providers are encouraged
More informationOriana House, Inc. Substance Abuse Treatment. Community Corrections. Reentry Services. Drug & Alcohol Testing. Committed to providing programming
Oriana House, Inc. Committed to providing programming that changes lives and contributes to safer communities. Services include: Substance Abuse Community Corrections Reentry Services Headquartered in
More informationTreatment Approaches for Drug Addiction
Treatment Approaches for Drug Addiction NOTE: This fact sheet discusses research findings on effective treatment approaches for drug abuse and addiction. If you re seeking treatment, you can call the Substance
More informationNa#onal Trends in Addic#on Medicine. Ohio Chapter of the American Society of Addic4on Medicine 2017 Annual Mee4ng Wednesday, August 2, 2017
Na#onal Trends in Addic#on Medicine Ohio Chapter of the American Society of Addic4on Medicine 2017 Annual Mee4ng Wednesday, August 2, 2017 Ohio Chapter of the American Society of Addic4on Medicine 2017
More informationPROMISING SHORT TERM INTERVENTIONS:
PROMISING SHORT TERM INTERVENTIONS: THE UP & OUT PROGRAM Presented by Amy Woerner, LMSW Up & Out Social Worker Bronx Community Solutions WHAT THIS SESSION IS EXPLANATION OF THE GAP IN INTERVENTIONS OUR
More informationIntegrated Mindfulness Interven1on
Integrated Mindfulness Interven1on Elizabeth Berlasso, NSRCT, Psychotherapist Rob Dickson, Clinical Team Leader Tara Sampalli, PhD, Manager Minakshi Dhir, Research Associate Integrated Chronic Care Service,
More informationPolk County Problem Solving Courts
Polk County Problem Solving Courts Behavioral Health Court (BHC) Veteran s Court Docket Drug Court: Drug Court Laboratory Adult Drug Court Juvenile Drug Court DUI Drug Court PADC MM Drug Court PADC Felony
More informationEvaluation of an Enhanced Drug Treatment Court Santa Barbara County, California,USA
Evaluation of an Enhanced Drug Treatment Court Santa Barbara County, California,USA Merith Cosden June 19, 212 Drug Court Enhancements Address clients trauma Serve adults with co-occurring disorders Implement
More informationSUD Requirements. Proprietary
SUD Requirements Triage screening to determine eligibility and appropriateness (proper member placement) for admission and referral. A comprehensive bio-psychosocial evaluation must be completed prior
More informationIntegra(on of Behavioral Health and Risk Assessments Into Case Plans
Integra(on of Behavioral Health and Risk Assessments Into Case Plans Na4onal Reentry Resource Center Behavioral Health Training Summit August 4, 2015 New York, NY Council of State Governments Jus4ce Center
More informationADVANCED BEHAVIORAL HEALTH, INC. Clinical Level of Care Guidelines
The Clinical Level of Care Guidelines contained on the following pages have been developed as a guide to assist care managers, physicians and providers in making medical necessity decisions about the least
More informationChild Welfare and Substance Abuse. Erica Tarasovitch, MSW Central Florida Behavioral Health Network
Child Welfare and Substance Abuse Erica Tarasovitch, MSW Central Florida Behavioral Health Network Parental Substance Use Marijuana was the most commonly used illicit drug in 2006, accounting for 72.8
More informationintegration and payment in primary care settings
May 9, 2015 substance abuse treatment integration and payment in primary care settings Michael S. Shafer, Ph.D. Learning Objectives At the conclusion of this session, if I have done my job, you will: Demonstrate
More informationIntroduc7on to DBT DBT. Dialec7cal Behavior Therapy (DBT) Michele Galie*a, Ph.D. Associate Professor John Jay College of Criminal Jus7ce
Introduc7on to DBT Michele Galie*a, Ph.D. Associate Professor John Jay College of Criminal Jus7ce DBT DBT is a cogni,ve-behavioral therapy designed for the severe and chronic mul,-diagnos,c, difficult-to-treat
More informationMethadone Treatment. in federal prison
INFORMATION FOR FEDERAL PRISONERS IN BRITISH COLUMBIA Methadone Treatment in federal prison This booklet will explain how to qualify for Methadone treatment in prison, the requirements of the Correctional
More informationCorrectional Discharge Planning & the Missing Linkages
From the SelectedWorks of D'Andre Lampkin Spring April 4, 2016 Correctional Discharge Planning & the Missing Linkages D'Andre D Lampkin, National University This work is licensed under a Creative Commons
More informationMEETING PEOPLE WHERE THEY ARE
Advancing the Concept of Stages of Change & Treatment for Individuals with Co- Occurring Disorders MEETING PEOPLE WHERE THEY ARE Presented by Erwin Concepcion, Ph.D. LP 1 Objec,ves 1. Describe one primary
More informationNvLearn the Signs. Act Early. Au7sm and Referral March 27, Nevada Leadership Education In Neurodevelopmental and Related Disabilities
NvLearn the Signs. Act Early. Au7sm and Referral March 27, 2013 Nevada Leadership Education In Neurodevelopmental and Related Disabilities Acknowledgements Thank you to Centers for Disease Control for
More informationWhat is Treatment Planning? Clinical Evaluation: Treatment Planning Goals and Objectives
Clinical Evaluation: Treatment Planning Goals and Objectives 1) Define Treatment Planning 2) Understanding of Correlation Between Assessment and Treatment Planning 3) Overview of Treatment Planning Process
More informationDusty L Humes, Ph.D., Clinical & Forensic Services 2201 San Pedro NE, Building Albuquerque, NM
Dusty L Humes, Ph.D., Clinical & Forensic Services 2201 San Pedro NE, Building 4-102 Albuquerque, NM 87110 512.917.3126 Profile I am a clinical psychologist who relocated to Albuquerque from Austin in
More informationPSYCHOTROPIC MEDICATION UTILIZATION PARAMETERS FOR CHILDREN AND YOUTH IN FOSTER CARE
PSYCHOTROPIC MEDICATION UTILIZATION PARAMETERS FOR CHILDREN AND YOUTH IN FOSTER CARE Introduction and General Principles April 2017 Adapted for New Mexico from with permission from the Texas Department
More informationIncreasing the benefits of foster carer peer support
Increasing the benefits of foster carer peer support Nikki Luke and Judy Sebba Rees Centre for Research in Fostering and Educa;on rees.centre@educa;on.ox.ac.uk Rees Centre for Research in Fostering and
More informationEthics and Boundaries
Ethics and Boundaries Jim Seckman, MAC, CACII, CCS What are the defining characteris@cs of a profession? A body of knowledge A special group of skills Addresses a special problem Tes@ng for admission Lifelong
More information3726 E. Hampton St., Tucson, AZ Phone (520) Fax (520)
3726 E. Hampton St., Tucson, AZ 85716 Phone (520) 319-1109 Fax (520)319-7013 Exodus Community Services Inc. exists for the sole purpose of providing men and women in recovery from addiction with safe,
More informationMethadone Treatment. in federal prison
INFORMATION FOR FEDERAL PRISONERS IN BRITISH COLUMBIA Methadone Treatment in federal prison This booklet will explain how to qualify for Methadone treatment in prison, the requirements of the Correctional
More informationWomenʼs Health Day. Marsha McInnis, Family Member and President, NAMI Tri-Valley. September 25, 2008
Womenʼs Health Day Marsha McInnis, Family Member and President, NAMI Tri-Valley September 25, 2008 Introduc)on Depression Symptoms Depression Facts What Causes Higher Rate of Seeking Professional Help
More informationWorking With Women Who Are Victims of Domestic Violence & Substance Abuse
National Indigenous Women s Resource Center Presents Working With Women Who Are Victims of Domestic Violence & Substance Abuse Brenda Hill, Native Co-Director brenda@sdcadvsa.org South Dakota Coalition
More informationIndex. Handbook SCREENING & TREATMENT ENHANCEMENT P A R T STEP. Guidelines and Program Information for First Felony and Misdemeanor Participants
SCREENING & TREATMENT ENHANCEMENT P A R T Index Welcome to STEP 3 What is STEP? 4 What s in it for me? 5 STEP Rules 6-8 STEP Phase Description and 9-16 Sanction Scheme Graduation 17 STEP webready STEP
More informationIbogaine treatment for opioid dependence in New Zealand: A 12- month post- treatment follow- up observa>onal study
Ibogaine treatment for opioid dependence in New Zealand: A 12- month post- treatment follow- up observa>onal study Geoff Noller, PhD Substance Use and Policy Analysis In associa>on with Researching NZ
More informationPrac%cing and Thriving in an Unlicensed State
Prac%cing and Thriving in an Unlicensed State WHY? What can you do? How do you prac%ce? Don t you want to be in a licensed state? Naturo- what?? FEAR...the discouraging factor Legal Ramifica%ons Disregard
More informationOncology Care Model Overview
Oncology Care Model Overview Centers for Medicare & Medicaid Services Innova3on Center (CMMI) September 2017 Innova3on at CMS Center for Medicare & Medicaid Innova3on (Innova3on Center) Established by
More informationAsk the Doctor Webinar Series:
Ask the Doctor Webinar Series: Evidence Based Practices - Myths and Realities Dr. Fred Osher Director of Health Systems and Services Policy Council of State Governments Justice Center Today s Presentation
More informationPosi%ve Psychotherapy for Youth at Clinical High- Risk for Psychosis
Posi%ve Psychotherapy for Youth at Clinical High- Risk for Psychosis Lauren Drvaric, MSc. Psych., PhD. Candidate (co- inves%gator) Doctoral Research Trainee, Complex Mental Illness, Centre for Addic%on
More informationPolicy and interventions for adults with serious mental illness and criminal justice involvement
Policy and interventions for adults with serious mental illness and criminal justice involvement Allison G. Robertson, PhD, MPH Duke University School of Medicine Department of Psychiatry & Behavioral
More information2017 JDTC On-Site Technical Assistance Delivery REQUEST FORM
2017 JDTC On-Site Technical Assistance Delivery REQUEST FORM As part of the On-Site Technical Assistance request and planning process, we ask that your Juvenile Drug Treatment Court (JDTC) use this form
More informationCLINICALLY SUPERVISED EXPERIENCE for the Criminal Justice Professional (PAGE 1 of 2) APPLICANT S NAME SUPERVISOR S NAME AGENCY
CLINICALLY SUPERVISED EXPERIENCE for the Criminal Justice Professional (PAGE 1 of 2) APPLICANT S NAME SUPERVISOR S NAME AGENCY PROFESSIONAL LICENSES AND/OR CERTIFICATES YOU HOLD *Supervisors must include
More informationScreening and Assessment
Screening and Assessment Screening and assessment are two different ways to obtain mental health and substance use information about youth. Screening is typically a brief procedure, performed by non-mental-health
More informationE N V I R O N M E N T
E T H I C A L D I L E M M A : B A L A N C I N G P R O F E S S I O N A L R O L E S A N D S C O P E O F P R A C T I C E I N A N E V O L V I N G C L I N I C A L E N V I R O N M E N T E RW I N C O N C E P
More informationDUID and the Impact of Marijuana Legaliza9on on Traffic Safety
DUID and the Impact of Marijuana Legaliza9on on Traffic Safety Na9onal Law Enforcement Liaison Training Conference Linthicum Heights, MD November 15, 2017 Captain Bruce W. Sheetz, Colorado Highway Patrol
More informationIDDT Fidelity Action Planning Guidelines
1a. Multidisciplinary Team IDDT Fidelity Action Planning Guidelines Definition: All clients targeted for IDDT receive care from a multidisciplinary team. A multi-disciplinary team consists of, in addition
More informationThe Brief Cogni-ve Assessment Tool (BCAT): A New Test Emphasizing Contextual Memory and Execu<ve Func<ons
The Brief Cogni-ve Assessment Tool (BCAT): A New Test Emphasizing Contextual Memory and Execu
More informationAddressing Co-Occurring Disorders in Court-Based Programs
Addressing Co-Occurring Disorders in Court-Based Programs Roger H. Peters, Ph.D. Professor; Department of Mental Health Law and Policy at the Louis de la Parte Florida Mental Health Institute (FMHI), University
More informationChild and Adolescent Screening and Assessment Tools
Child and Adolescent Screening and Assessment Tools Randall Stiles, PhD. State of Nevada Division of Child and Family Services The views, opinions, and content expressed in this presentation do not necessarily
More information