PRINCIPLES -CONSIDERATIONS

Robert Neri, LMHC, CAPSenior Vice President/Chief Clinical OfficerWestCare Foundation, Inc.

PRINCIPLES - CONSIDERATIONS

A Brief History LessonA Brief History Lesson

InIn

RecoveryRecovery

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

Good Mental Health

is the Early Attention to Crisis

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

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

HIGH PAIN HIGH HOPE

LOW PAIN LOW HOPE

PRINCIPLES – CONSIDERATIONS

EXTERNAL MOTIVATIONEXTERNAL MOTIVATION (Coercion)

IS A GOOD THING!External

Internal

PRINCIPLES – CONSIDERATIONS

STILL USE:

“Trust and Verify”

Understand Relapse is Usually Situational

PRINCIPLES – CONSIDERATIONS

HIGH RISK SITUATIONS:HIGH RISK SITUATIONS:

• Relationship Changes

• Transitional Periods: Living Situation Changes Employment Changes Loss of a Relationship Health Conditions Changes

PRINCIPLES – CONSIDERATIONS

Questions/Discussion

Thank You!