Center for Practice Innovations Brings Best Practices to NYS: Focus on Integrated Treatment (FIT) and ACT Institute NYAPRS Conference September 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?

Web-based Collaborations On-line training Distance Learning

Building best practices with you.

Focus on Integrated Treatment

Receive treatment whether you walk into an OMH-licensed or OASAS-certified program. What is integrated treatment for People with Co-Occurring Mental Health and 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 sensitive Drake, RE, Essock, SM, et al. (2001). Psychiatric Services, 52, What does integrated treatment for COD include?

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, 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 Initiative

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 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 Learning Log in and complete modules when convenient Re-review modules any time New staff trained immediately and consistently

35 Modules by December 2010 Video Skill Demonstrations Interactive Exercises Recovery Stories

22 Modules Now Available! 22 Modules Now Available! Stage-wise Treatment Cognitive- behavioral therapy Motivational Interviewing

Screening & Assessment Individual collaborative treatment Peer Recovery supports

Supervision Capability & Fidelity Leadership

Distance Implementation Supports for Practitioners, Supervisors, and Agency Leaders Monthly Webinars Ask an Expert on LMS Discussion threads on LMS Monthly Calls

What 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 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 Institute ACT Institute Current Activities and Future Directions

ACT Model Interdisciplinary Community-based Comprehensive services 24 hour coverage

Client characteristics (n=5000) Percent Male58 Female42 Diagnosis Schizophrenia77 Bipolar Disorder17 Other8 Co-existing substance abuse57 High use of psychiatric hospitals 55 Current AOT order22

Values & Philosophy Recovery Individualized Shared decision-making Culturally informed

Core Training Part One (2 days) Recovery Cultural competence Engagement Assessment & treatment planning Treatment services Transition planning Part Two (2 days) Person-centered treatment planning

Consultation New teams and team leaders Referrals from NYSOMH Self-referral

EBP training Supported employment, integrated dual diagnosis treatment, family psychoeducation Consultation Web-based resources

New directions Web-based training Core EBP