Center for Practice Innovations Brings Best Practices to NYS:

Focus on Integrated Treatment (FIT) and ACT Institute

NYAPRS ConferenceSeptember 23, 2010

Carlos Jackson, Ph.D.Paul Margolies, Ph.D.Nancy Covell, Ph.D.Dan Herman, Ph.D.

Who we are?

Public-Academic Partnership

Paul Margolies, Ph.D.Associate Director

Implementation

Carlos Jackson, Ph.D.Associate Director

Operations

Susan Essock, Ph.D.Director

Dan Herman, Ph.D.Director,

ACT Institute

Nancy Covell, Ph.D.Project Director,

Focus on Integrated Treatment

What we do?

www.practiceinnovations.orgWeb-based CollaborationsOn-line trainingDistance Learning

Building best practices with you.

Focus on Integrated TreatmentFocus on Integrated Treatment

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

What is integrated treatment for People What is integrated treatment for People with Co-Occurring Mental Health and with Co-Occurring Mental Health and

Substance Use Disorders (COD)?Substance Use Disorders (COD)?Both mental health and substance use treatment provided by the same clinician or team.

No Wrong Door

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

What does integrated treatment for What does integrated treatment for COD include?COD include?

Integrated Treatment is Effective!Integrated Treatment is Effective!

People achieve abstinence or really cut down on substance use

They get their own apartments or homes

They get jobs

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.

They make friends with people who don’t use substances

Their mental health symptoms improve and they are happier with life overall.

Overview of the FIT InitiativeOverview of the FIT Initiative

What is Unique about FIT?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 LearningAdvantages to Distance Learning

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

Travel costs are eliminated

No cancelled trainings (e.g., for weather ) resulting in lost resources

Advantages to Distance LearningAdvantages to Distance LearningLog in and complete modules when convenient

Re-review modules any time

New staff trained immediately and consistently

35 Modules by December 201035 Modules by December 2010

Video Skill

Demonstrations

InteractiveExercises

Recovery

Stories

22 Modules Now Available!22 Modules Now Available!

Stage-wise

Treatment

Cognitive-behavioraltherapy

Motivational Interviewing

Screening &Assessment

Individual collaborative treatment

Peer Recoverysupports

Supervision

Capability &

Fidelity

Leadership

Distance Implementation SupportsDistance Implementation Supportsfor Practitioners, Supervisors, and Agency Leadersfor Practitioners, Supervisors, and Agency Leaders

Monthly Webinars

Ask an Expert on LMS

Discussion threads on LMS

Monthly Calls

What learners are sayingWhat 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 sayingWhat 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.”   

ACT InstituteACT Institute Current Activities and Future Directions

ACT ModelACT Model

• Interdisciplinary

• Community-based

• Comprehensive services

• 24 hour coverage

Client characteristics (n=5000)Client characteristics (n=5000)Percent

Male 58

Female 42

Diagnosis

Schizophrenia 77

Bipolar Disorder 17

Other 8

Co-existing substance abuse 57

High use of psychiatric hospitals

55

Current AOT order 22

Values & PhilosophyValues & Philosophy

• Recovery

• Individualized

• Shared decision-making

• Culturally informed

Core TrainingCore Training

• Part One (2 days)• Recovery• Cultural competence• Engagement• Assessment & treatment planning• Treatment services • Transition planning

• Part Two (2 days)• Person-centered treatment planning

ConsultationConsultation

• New teams and team leaders

• Referrals from NYSOMH

• Self-referral

EBP trainingEBP training

• Supported employment, integrated dual diagnosis treatment, family psychoeducation

• Consultation

• Web-based resources

New directionsNew directions

• Web-based training• Core• EBP