PRINCIPLES -CONSIDERATIONS
Robert Neri, LMHC, CAPSenior Vice President/Chief Clinical OfficerWestCare Foundation, Inc.
PRINCIPLES - CONSIDERATIONS
Learning Objectives / Topics covered will be:
1. Examples of Co-occurring Conditions2. Co-Occurring Complicating Issues 3. Identify Recovery Factors4. Intervention Strategies5. Risk Considerations with Overdose and Suicide
Prevention6. Identifying High-Risk Situations
Substance Abuse/Mental Health Substance Abuse/Mental Health
are are
Treatable Diseases/DisordersTreatable Diseases/Disorders
PRINCIPLES - CONSIDERATIONS
PRINCIPLES - CONSIDERATIONS
Substance Abuse Substance Abuse
is a preventable behavioris a preventable behavior
AddictionAddiction
is a treatable diseaseis a treatable disease
PRINCIPLES - CONSIDERATIONS
Co-Occurring Disorders Co-Occurring Disorders
are the Rule…Not the Exceptionare the Rule…Not the Exception
PRINCIPLES - CONSIDERATIONS
Some Examples of Co-Occurring:
• Substance Abuse/Mental Health• HIV or Multiple Chronic Conditions• Learning Disabilities• Anxiety, Depression, PTSD, TBI
PRINCIPLES - CONSIDERATIONS
Complicating Issues: • Arrested Development (Maturity)• Habilitation vs. Rehabilitation• Criminality (Crime Before Drugs)• Social Skill Deprivation • Treatment Retention & Medical Adherence
PRINCIPLES - CONSIDERATIONS
Complicating Issues: (continued)
• Youthful 18 – 26• Corrective Thinking• Stigma
PRINCIPLES - CONSIDERATIONS
Recovery Factors:• Integrated Care• Dosage – Length of Stay• Therapeutic Alliance• Evidence Based Approach (MI/CBT)• Family Support• Treatment is Cumulative
PRINCIPLES - CONSIDERATIONS
Recovery Factors: (continued)
• The Treatment/Public Safety
• Continuum Aligned
PRINCIPLES – CONSIDERATIONS
Intervention:
•Pay Attention to Behavior ~ Don’t Diagnose
•Expectations and Accountability•Refer and Assist with Navigating the System
PRINCIPLES – CONSIDERATIONS
Intervention: (continued)
• Refer to Contracting Agencies • Managed Care/Medicaid Providers• EAP/DCF/VA/DOC Providers
PRINCIPLES – CONSIDERATIONS
•Use Risk Screening •Refer Quickly
A Word About Overdoseand Suicide Prevention
PRINCIPLES – CONSIDERATIONS
EXTERNAL MOTIVATIONEXTERNAL MOTIVATION (Coercion)
IS A GOOD THING!External
Internal
PRINCIPLES – CONSIDERATIONS
HIGH RISK SITUATIONS:HIGH RISK SITUATIONS:
• Relationship Changes
• Transitional Periods: Living Situation Changes Employment Changes Loss of a Relationship Health Conditions Changes