It is understandable that individuals struggling with substance abuse problems are often highly ambivalent about engaging and committing to treatment and recovery, especially upon initial contact with a helping professional. The skills of engagement and enhancement of client motivation are thus critical for anyone seeking to effectively assist substance-involved populations. Additional understanding of and ability to appropriately assess individuals according to whole-person frameworks is also important. This set of learning session will focus on these foundational knowledge and skill areas, as well as touching on broad, well-established treatment approaches for successfully addressing addictive disorders.
Identify nine evidence-based relational elements and describe why valuing the client relationship is important.
Describe the importance of engagement and how it relates to the entire therapeutic/treatment sequence.
List the four variables in the "change equation" for difficult behavior, and their relative importance.
Identify six stages in the transtheoretical model of change.
Describe why it is important to identify a client's stage of change before attempting treatment interventions.
Describe the primary goals and types of interventions corresponding with the four stages of treatment.
Describe the four phases of working with clients in the motivational interviewing framework.
Identify the 5 strategic skills of motivational interviewing and describe how they are useful in working with ambivalent clients.
Describe how the spirit of motivational interviewing is different from some traditional addictions treatment approaches.
Distinguish between simple and complex forms of reflective listening.
Describe ten techniques for evoking change talk.
Distinguish between four types of preparatory change talk and three types of mobilizing change talk.
Identify the acute withdrawal syndromes from depressant, stimulant, and hallucinogenic substances of abuse.
Describe how neurochemistry functions in both intoxication and withdrawal syndromes and their associated symptoms.
Describe three relapse prevention strategies, and how to address the challenges of post-acute withdrawal from various substances.
Identify the 12 Steps and 12 Traditions of Alcoholics Anonymous and their various wider applications.
Compare and contrast the 12-Step model/approach with other peer-led models/approaches.
Describe how to build and leverage partnerships with 12-Step fellowships and other peer-led support groups in the local community.
Describe the efficacy findings of cognitive behavioral therapy from the Project MATCH research study.
Identify five distinctive elements of cognitive behavioral therapy compared with other intervention models.
Describe two evidence-based applications of cognitive behavioral approaches, for use with clients addicted to alcohol, and to cocaine.
Describe the differences between didactic, process, and skill-building treatment groups.
Describe how utilizing three different types of group work enhances treatment effectiveness at different stages.
Identify content/curriculum for use in delivering each of the three levels of stage-matched group work.
Describe values, ethical principles, and ethical standards for addiction treatment providers.
Describe specific ethical dilemmas that arise in addictions practice.
Differentiate between compliance and ethical practice regarding guidelines for behavioral health professionals, according to the requirements of licensing, ethical codes, and state/federal requirements.
Describe the process for ethical decision-making when competing ethical considerations are at play in addictions practice situations.
Apply ethical principles to culture and spirituality in addictions treatment.
Describe specific ethical issues within addictions treatment related to harm reduction.
Successful treatment of addictive disorders typically includes various elements and processes that the effective practitioner needs to not only know about, but also to know how best to invoke those treatment elements in a manner that will be the best fit for each individual service recipient. Additionally, there are time-tested, evidence-based therapies with proven positive outcomes that practitioners would benefit from knowing about, either for direct provision or for the purposes of informing referrals. This set of sessions will focus on these learning targets, as well as equipping participants with the professional ethics knowledge and perspectives necessary for working with substance-involved populations.
Describe the six dimensions of the American Society of Addiction Medicine's Patient Placement Criteria (ASAM PPC-2R), and how they inform level-of-care determination and referral.
Describe how screening is critically related to assessment and treatment planning.
Identify five brief screening instruments and describe how they may be effectively utilized.
Describe the importance of providing a menu of treatment options during initial orientation to services.
Describe how orientation and education are in themselves important interventions impacting subsequent treatment.
Describe a comprehensive source of quality, low-cost, substance-specific educational materials and how to access them.
Describe the 4 diagnostic criteria elements for Substance Abuse and the 7 criteria elements for Substance Dependence from the DSM-IV, and the changes to Substance Use Disorder diagnostic criteria in the DSM-5.
Describe how assessment is critically related to treatment planning.
Demonstrate how to conduct effective, recovery-oriented, strengths-based, stage-matched treatment planning.
Identify the 6 stages of the Transtheoretical Model of Change align with the 8 stages of the Substance Abuse Treatment Scale (SATS), and describe how each are important, useful frameworks.
Describe how to adjust stage-matched treatment planning as recovery occurs.
Demonstrate how to write useful stage-matched progress notes.
Describe how family systems theory informs the understanding of addiction as a "family disease" and associated treatment strategies.
Identify the 3 concepts of enabling, codependence, and the Drama Triangle, and describe how to present these concepts to clients and "family" members, including family-of-origin, family-of-procreation, and family-of-choice.
Identify available recovery support resources for family members, how to access them, and why they are important.
Describe the differences between "social," "subacute," and "medical" detox, and when each of these 3 is indicated.
Describe the pros and cons of the strategies of pharmacologically assisted detox vs cold turkey.
Identify 5 psychosocial strategies used to support clients through withdrawal from different substance.
Describe the efficacy findings of Motivational Enhancement Therapy from the Project MATCH research study.
Identify 5 distinctive elements of Motivational Enhancement Therapy compared with other intervention models.
Describe scripted session guidelines for delivering the Motivational Enhancement Therapy intervention.
Describe the efficacy findings of Twelve-Step Facilitation therapy from the Project MATCH research study.
Identify 5 distinctive elements of Twelve-Step Facilitation therapy compared with other intervention models.
Describe scripted session guidelines for delivering the Twelve-Step Facilitation therapy intervention.
Describe how the concepts of operant conditioning, and positive and negative reinforcement impact behaviors in the direction of addiction or recovery.
Identify the 5 steps for designing an effective Contingency Management program.
Describe what research findings indicate about the effective use of Contingency Management in addiction treatment.
Describe the difference between empowering and enabling and why it is important in treating addictive disorders.
Identify 5 strategies in empowerment and advocacy for and with clients with substance use disorders.
Describe the importance of case management services being aligned with overall treatment goals and efforts.
As behavioral healthcare service delivery has become increasingly concerned with effective treatment for co-occurring mental health and substance use disorders, integrated care models, and dual-diagnosis-informed interventions have emerged and become well- established. The more recent acknowledgement of the importance of further integration with physical healthcare treatment services is also highly pertinent to successful and sustainable treatment of substance-involved populations. This set of learning sessions will focus on addictions treatment with individuals having complex and comorbid circumstances and conditions, including mental health, physical health, criminal justice, and trauma issues.
Identify the 26 domains of the Integrated Dual Disorders Treatment model, and which are most impactful.
Identify the 7 domains of the "Dual Diagnosis Capability" framework for application to traditional substance abuse (DDCAT), mental health (DDCMHT), and primary care (DDCHCS) programs.
Describe how to access useful cost-free information and resources to develop or enhance dual disorders treatment delivery.
Describe the pros and cons of different approaches to considering culture and ethnicity in addictions treatment.
Identify 12 gender-responsive principles for addressing the specific substance abuse treatment needs of women.
Identify 5 important cultural issues when working with LGBT individuals.
Identify 6 key principles and 4 models of Drug Court programs and describe the demonstrated efficacy of this approach.
Describe other ways of integrating addictions treatment with legal case processing including strategies for interfacing with probation and parole departments.
Identify the 8 elements of transition planning to support continuity of offender treatment for substance use disorders from institution to community.
Identify 3 historical barriers and bridges between spirituality/religion and addictions treatment.
Demonstrate how a comprehensive assessment of client spirituality can effectively inform treatment planning.
Identify 9 guidelines for using religious/spiritual interventions in addictions treatment.
Describe physical health sequelae that are indicators of at least 3 different types of substance abuse.
Describe the relationship between HIV, Hepatitis B & C, and other infectious diseases and substance abuse.
Describe smoking cessation treatment interventions in primary care and addictions treatment settings.
Describe how symptoms of intoxication/withdrawal interact in toxic fashion with personality disorder symptoms.
Describe how personality disorder symptoms are both a risk factor for, and consequence of, various addictions.
Describe the effective treatment model for Borderline Personality Disorder and Addiction of Dialectical Behavior Therapy-S.
Describe how 3 symptoms of intoxication/withdrawal syndromes mimic anxiety disorder symptoms.
Describe how anxiety disorder symptoms are both a risk factor for, and consequence of, various addictions.
Identify 4 psychosocial strategies for managing anxiety without potentially addictive medications.
Describe how 3 symptoms of intoxication/withdrawal syndromes mimic mood disorder symptoms.
Describe how mood disorder symptoms are both a risk factor for, and consequence of, various addictions.
Identify the risks of 2 different approaches to addressing mood disorder symptoms in addiction treatment.
Describe how 3 symptoms of intoxication/withdrawal syndromes mimic thought disorder symptoms.
Describe how thought disorder symptoms are both a risk factor for, and consequence of, various addictions.
Identify 3 ways of adjusting co-occurring addictions treatment for clients with significant cognitive impairment.
Describe prescribing protocols/strategies for managing the use of potentially abusable medications.
Identify 4 medications prescribed as strategies for assisting recovery efforts, and when they may be indicated.
Describe methadone treatment for opioid addiction, and what the research evidence shows regarding efficacy.