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Co-Occurring Competency Series

Co-Occuring Competency Series

Please see online registrations below:

Integrating Treatment for Persons with Co-Occurring Mental and Substance Use Disorders

9/11/19 1:00 – 4:00

This seminar provides an overview of what is needed for recovery from all existing conditions, including psychiatric and substance use disorders. The course examines organizing principles and tools. It explores the scope of what practitioners who work with persons from a variety of cultures may need in order to acquire basic competency in this area. It also reviews the terms in the Co-Occurring Competency Bulletin released conjointly in February 2006 by the Department of Health and the Department of Public Welfare.

This seminar is the introduction for those taking the full COD course series and lists expectations for additional reading.

Course Objectives: Participants will be able to:

  • Define “co-occurring disorders” and what constitutes “integrated approaches” to working with persons having CODs;
  • Examine major concepts and approaches currently in the literature;
  • Review personal attributes and skills needed for effectively working with persons having CODs;
  • Explore the contents of Pennsylvania’s COD Competency Bulletin;
  • Identify resources useful in gaining more knowledge about effective practices in COD.

Principles of Engagement with the Person, Family and Others

9/25/19 1:00 – 4:00

This seminar examines the importance of creating a working relationship with all involved: people beginning treatment; their family members; and other support persons. Participants will examine their own engagement skills and review principles of strengths-based and culturally-responsive practices. A brief overview of change theory and Motivational Interviewing skills is presented, as are general attitudinal and behavioral attributes needed in order to be welcoming and respectful. Practice in sustaining a recovery-oriented environment is included.

Course Objectives: Participants will be able to:

  • Describe components of a welcoming environment and its opposite;
  • Identify specific behaviors that demonstrate welcome and respect;
  • Review basic principles and components of strengths-based practice, change theory and Motivational Interviewing;
  • Self-evaluate personal strengths and needs regarding engagement skills;
  • Practice engagement skills in a safe and supportive setting.
Co-occurring Disorders and Psychopharmacology: An Overview

*10/4/19 9:00 – 4:00

This seminar reviews basic classes of psychoactive medications (including newer ones), their uses and limitations, potential major side effects and possible serious interactions. Actions of the medication in the brain and body are presented in a simplified form, as are cultural-ethnic variations connected to biology, beliefs and practices when prescribing specific medications. The use of the Physician’s Desk Reference and the pharmacist for information is explained, and the role of the physician/psychiatrist as a collaborative treatment team member (as presented in the SAMHSA tool kit “Medication Management Approaches in Psychiatry”) is referenced. Partnering with the person (and family) to assist with managing adherence to a medication regimen is discussed in terms of the person’s overall recovery management.

Course Objectives: Participants will be able to:

  • Review basic brain structure and function and the potential effects of brain-based disorders, including major mental and substance-related disorders;
  • Identify classes of psychotropic medications, including their uses, side effects, and risks;
  • List potential interactions of classes of psychotropic medications with alcohol and street drugs, including level of risk;
  • Examine current evidence-based practice techniques for prescribing and monitoring psychotropic medications, including collaborative work with the person taking these medications (and their family members);
  • Discuss means of working with persons and family members across cultures to support knowledge-based choices about medications, including factors related to adherence.

Recovery, Rehabilitation and Self-Help: What, When and How

10/9/19 1:00 – 4:00

This seminar focuses on the internal processes and stages of recovery and possible supports needed. It discusses the structures and uses of psychiatric rehabilitation for facilitating recovery and providing needed skills and alternative coping strategies.

The diverse forms of self-help are reviewed and the necessity for the availability of choices discussed. The current focus of PA OMHSAS on the creation of recovery-oriented systems and programs is reviewed. The importance of work in people’s lives is referenced, and the SAMHSA tool kit on “Supported Employment” is cited. Housing issues will also be discussed.

Course Objectives: Participants will be able to:

  • Cite research-based findings regarding personal recovery and what supports this process;
  • Describe ways different activities (e.g., 12-step programs, drop-in centers, clubhouses, psychoeducational groups) can support personal recovery;
  • Examine the values and principles of psychiatric rehabilitation, the importance of meaningful work and/or related activities, and how these related to persons with CODs;
  • Identify ways of working with individuals who have CODs that are collaborative rather than “expert” means for establishing a relationship and supporting the person’s active choice;
  • Discuss the importance of Hope for both the person and those who provide treatment and support services.

Approaches to Assessment, Treatment and Supports

10/23/19 1:00 – 4:00

This seminar builds on material discussed in the Introduction and Engagement seminars. The first half of the course examines screening and assessment needs and means of acquiring the data needed for useful clinical decision-making. The second half provides an overview of the types of treatment approaches that may be most useful for persons with differing disorders and levels of symptom severity, including examination of cultural/ethnic variations, environmental supports and stressors, and peer supports.

Course Objectives: Participants will be able to:

  • Explain components of assessment and the assessment process;
  • Identify attitudes and skills needed by those conducting COD assessments;
  • Review some existing treatment approaches found useful for persons with different diagnostic combinations, change readiness, and levels of symptom severity;
  • Discuss means of identifying, locating and linking other needed supports;
  • Describe cultural elements to be considered in exploring specific approaches and supports.

Ethics and Boundaries for Effective Practice

*11/1/19 9:00 – 4:00

This seminar addresses the ethical principles on which all human service endeavors are based and the specific areas of practice where boundary issues arise (including HIV+, confidentiality, working with peers who are in recovery, cross-cultural concerns, the use of Psychiatric Advance Directives, and other issues related to legality and ethics). Practice concerns that arise in different roles and practice settings (non-traditional services) are specifically examined, including some ethical concerns regarding practice in the context of a managed care environment.

Course Objectives: Participants will be able to:

  • List the ethical principles of all practice in human services;
  • Explore issues regarding role and practice boundaries;
  • Review some differences in law and regulations governing mental health and substance-related treatment agencies and practitioners, and their effects on integrated practice;
  • Identify areas of operation within a managed care environment that may present specific challenges to ethical practice, including ways to reduce such risks;
  • Discuss personal advocacy as central to the ethical practice of one’s profession.

Working Respectfully with Family Member and Significant Others

11/6/19 1:00 – 4:00

This seminar is focused on working in partnership with family members rather than continuing cycles of blame and misunderstanding. The importance of understanding cultural variations, creating a welcoming, inclusive atmosphere, and understanding the particular and valuable expertise of family members is discussed. Means of connecting families with systems that meet their multiple needs are reviewed, as is providing program components to assist family members in helping their ill member. The SAMHSA tool kit “Family Psychoeducation” is referenced.

Course Objectives: Participants will be able to:

  • Examine the role and dynamics of the family, especially in relation to coming to terms with having a member with a COD;
    • Explore both the benefits of, and barriers to, working in partnership with family members and significant others to acquire educational resources and other supports;
    • Identify personal biases and cultural variations that affect work with family members/significant others, including the feelings and thoughts that support these biases;
    • Discuss steps needed for meeting family members/others in welcoming and respectful ways and involving them as collaborative team members;
    • Assist family members in evaluating their own responses and in finding ways to reduce risks both to the person having a COD and the family.

    Treatment Planning and Documentation Issues

    11/13/19 1:00 – 4:00

    This seminar provides an opportunity for participants to review current evidence supported principles of collaborative treatment planning, including: working from a comprehensive assessment; using stage of change theory; identifying and mutually setting long- and short-term goals; identifying steps for accomplishing goals, the persons responsible, and a defined time line; and reviewing and altering such plans when necessary. Progress tracking is reviewed, including how to write clear and concise notes, and the principles for what to include and who may review them. Building on previous seminars, this course focuses on effective engagement and treatment principles and the practices of writing and reviewing plans and related documentation. It will not address details of how to write your agency’s forms.

    Course Objectives: Participants will be able to:

    • Review the principles and processes which support thorough and accurate assessment and diagnosis, including cross cultural issues;
    • Explore each step in treatment/service planning, its rationale, and the similarities and differences in service and treatment planning;
    • Discuss the use of change theory and motivational interviewing in “planning to plan;”
    • Define the components of integrated planning from a recovery and strengths perspective, including the principles of collaboration and choice;
    • Identify means of writing brief and useful progress notes and using them with the person to assess progress and use strategies that support movement towards positive outcomes.

    Crisis Prevention, Intervention and Relapse Planning

    12/4/19 1:00 – 4:00

    This seminar briefly reviews the cycle of crisis vulnerability, crisis state, and resolution. It also explores means of preventing crisis-creating situations, designing interventions for lowering arousal, and creating opportunities for teaching new coping skills in the direct aftermath of a crisis. Factors influencing aggression-prone reactions are discussed, as is the difference between “acting out” and purposeful or predatory violent acts. The relationships among stress and symptom management and relapse prevention are explored. Relapse prevention planning processes are presented that are useful for persons with CODs.

    Course Objectives: Participants will be able to:

    • Define “crisis” and “emergency” and identify major symptoms and stressors that contribute to higher risk potential for a crisis;
    • Identify means of quickly assessing the person, the environment and oneself in order to promote safety and limit the duration and severity of the crisis situation;
    • List stages of a crisis and some specific interventions most useful at each stage;
    • Design individual and group interventions and use tools to help persons recognize their own crisis risks and to create relapse prevention plans;
    • Discuss ways in which crises can be learning and growth-producing experiences for persons with CODs and how practitioners can facilitate this process.

    Groups and Group Skills

    12/18/19 1:00 – 4:00

    This seminar briefly reviews principles and skills needed in developing specific kinds of group modalities (including one-session, stand-alone groups) and for developing group goals, norms and processes. The needs of persons with various combinations of dual and multiple disorders are discussed, and means of matching group processes and leader activities to the specific needs of group members are presented (including variations in communication, learning, etc. style considerations and having members assist with focus/topic selection). Psychoeducational, skills-based, and cognitive behavioral groups are briefly reviewed. Participants explore the use of tool kits such as the SAMSHA EBP “Illness Management and Recovery,” TIP #42, and how to locate and use existing curricula. The therapeutic value of groups and the use of coleaders are also discussed.

    Course Objectives: Participants will be able to:

    • Identify the multiple uses of group approaches and the potential benefits and risks of group membership, including peer support groups;
    • Examine diagnostic combinations and individual characteristics that may suggest using individual or group approaches to provide interventions matched to stage of change;
    • Define the components and uses of psychoeducational, skills-building and CBT groups and their expected results for participants;
    • Outline leadership skills required for conducting groups whose members have cognitive impairments and/or mood instability and how these may differ from traditional groups;
    • Discuss resources for helping leaders with group process/content and how to locate them.