Report on Training Modules
“Mental Health and Dual
Diagnosis”
Held in: Lisbon, 6th, 13th and 15th November 2010
Schedule: 9.00 am – 1.00 pm and 2.00 pm – 5.30 pm
6 de Novembro 2010
(Sábado)
13 de Novembro 2010
(Sábado)
9:00
9:00
9:30
9:30
10:00
1'30''
10:00
Módulo 1
10:15
9:00
9:30
1'30''
Módulo 2
10:15
10:30
15 de Novembro 2010
(Segunda-feira)
10:00
10:30
Intervalo (15'')
Intervalo (15'')
10:45
10:45
10:45
11:00
11:00
11:00
11:30
11:30
11:30
2'15''
12:00
Módulo 1
2'15''
Módulo 2
12:15
12:15
12:30
12:30
12:30
13:00
13:00
13:00
Almoço (60'')
14:30
15''
14:30
Módulo 1
15:00
15:00
15:30
15:30
1'30''
15:45
16:00
16:00
Módulo 1
Módulo 3
Módulo 4
16:30
Almoço (60'')
14:30
1''
Módulo 4
15:00
Intervalo (15'')
Intervalo (15'')
15:45
1'45''
1'
14:00
14:15
Intervalo (15'')
16:30
Módulo 2
14:15
1'30''
Módulo 3
Almoço (60'')
14:00
14:15
1'15''
12:00
12:15
14:00
Módulo 3
10:30
Intervalo (15'')
12:00
1'30''
10:15
15:15
15:45
16:00
1'45''
Módulo 3
17:00
17:00
17:00
17:30
17:30
17:15
Módulo 1
7 horas
1'30''+2'15''+1'30''+1'45''
Módulo 2
4 horas
1'30''+2'15''+15''
Módulo 3
6 horas
1'30''+1'45''+1'30''+1'30''
Módulo 4
4 horas
1''+1'+1'45''
1'45''
Módulo 4
15''
Avaliação da Acção
16:30
Total 21 horas
Projecto financiado com o apoio da Comissão Europeia.
A Informação contida nesta publicação (comunicação) vincula exclusivamente o autor, não sendo a Comissão responsável pela utilização que dela
possa ser feita.
Programme:
6th November 2010 (Saturday)
First Module
Basic knowledge of Dual Diagnosis
Duration: 7 hours
Trainers: Maria Filomena Amaro (psychiatric); Maria João Gonçalves (psychologist at CERCIZIMBRA) and
Sónia Fontes (psychologist at FENACERCI)
Methodology: Theoretical presentations and discussion in plenary
Mental health – What is it?
a)
b)
Mental Health Importance and Concepts
Bio-Psycho-Social Model of Human  Health
Front Line staff and Service Provide role in the Mental Health Promotion
a)
b)
b)
Introduction
International Concepts

Community Based Rehabilitation

ONU Convention

Disability European Strategy

ICF

QoL
i. Concepts and implications
ii. Multiple concept
iii. WHO Concept
iv. Characteristics
v. Domains
National Concepts

National Health Plan

National Mental Health Plan

National Health System Referenciation procedures
Particular Issues of ID
a)
b)
c)
d)
e)
f)
ID Definition
ID Assessment and Classification
Why do PwID have vulnerability to mental health problems?
Life Cycle Approach
Challenge Behaviour
Mental Health Promotion for PwID
Mental Health Disease and Expression of Mental Health disease or problems in PwID
a)
b)
c)
d)
e)
Mental Health Problems Incidence in PwID
Recognizing Mental Health Problems in PwID
Mental Health Disease Expressions in PwID
What’s the relation between mental health problems and challenging behaviour?
Autism expressions
13th November 2010 (Saturday)
Second Module - 4 hours
Mental health (professional and personal experience)
Duration: 3,5 hours
Trainer: Rui Martins (psychologist at Associação ARISCO)
Methodologies: Role –playing and discussion in plenary
Duration: 0,5 hours
Trainers: Maria Filomena Amaro (psychiatric); Maria João Gonçalves (psychologist at CERCIZIMBRA);
Sónia Fontes (psychologist at FENACERCI)
Methodologies: theoretical presentations and discussion in plenary
Projecto financiado com o apoio da Comissão Europeia.
A Informação contida nesta publicação (comunicação) vincula exclusivamente o autor, não sendo a Comissão responsável pela utilização que dela
possa ser feita.
Mental health – What is it?
a)
Role Playing

Apresentação com Objectos – Quem é que eu sou? Sou o que quero ser ou o que posso ser? Acomodo-me ou
vou em busca? Negoceio?

Atento aos Sinais – Como me posiciono face ao outro. Definição de limites. Jogar o jogo social…
o
Discussion in plenary

Ocupação de espaço – O Espaço Vital. Entre as minhas necessidades e as condições existentes. A boa
educação como processo de gestão da agressividade face a invasão do outro…

Anéis Humanos – processo de separação/individuação – os vínculos, a autonomia, os recursos para crescer,
as implicações da falta de recursos…
o
Discussion in plenary
b)
Theoretical presentations and discussion in plenary

Mental Health Risk Factors
o
Social and Economics
o
Emotional and Psychological
o
Physical

Mental Health Protection Factors
Stress – what is it?
c)
d)
Role Playing

Com escritos na Testa – as interacções que mexem connosco no jogo social. Decisões de protecção: jogar ou
retirar-se para as margens…
o
Discussion in plenary

Banca dos Sentimentos – os outros como fontes de recursos e protecção. O retraimento e o empobrecimento
por falta de troca. O valor do que pensamos ser mau. O preço da mudança.
o
Discussion in plenary
Theoretical presentations and discussion in plenary

Stress Sources

Stress Effects

Stress Management Responses

Strategies to prevent stress
13th November 2010 (Saturday) and 15th November 2010 (Monday)
Third Module
Multidisciplinary team interventions
Duration: 6 hours
Trainers: Maria Filomena Amaro (psychiatric); Maria João Gonçalves (psychologist at CERCIZIMBRA) ;
Sónia Fontes (psychologist at FENACERCI)
Methodologies: theoretical presentations, discussion of case studies, work in small groups, report back
to the group in plenary
Mental Health of PwID
a)
b)
c)
Mental Health of PwID
Mental Health Problems in PwID
Psychiatric Evaluation

When and Why?
Comprehensive Model to reference, assessment and intervention planning in multidisciplinary team
a)
b)
c)
d)
e)
f)
Reference and assessment in multidisciplinary team
Risk Analysis procedures
Case discussion and diagnosis
Intervention planning

Intervention Context

Intervention Strategies Definition
i. Preventive
ii. Therapeutically
iii. Pharmacologic
iv. Parallel Interventions
Assessment, Communication and Feed-back
Work in small groups and report back to the group in plenary
Emotion Expression in PwID
a)
Strategies to facilitate Emotion Expression in PwID
Projecto financiado com o apoio da Comissão Europeia.
A Informação contida nesta publicação (comunicação) vincula exclusivamente o autor, não sendo a Comissão responsável pela utilização que dela
possa ser feita.
15th November 2010 (Monday)
Fourth Module
Emotional support strategies
Duration: 3,5 hours
Trainer: Rui Martins (psychologist at Associação ARISCO)
Methodologies: Role –playing and discussion in plenary
Duration: 0,5 hours
Trainers: Maria Filomena Amaro (psychiatric); Maria João Gonçalves (psychologist at CERCIZIMBRA) ;
Sónia Fontes (psychologist at FENACERCI)
Methodologies: theoretical presentations and discussion in plenary
Prevention of stress in the workplace
a)
b)
Role Playing

É Óbvio – do que é observável ao que é inferido e ao que é intuído – a criação de equívocos…

Manter os Balões no Ar – dominar os recursos pessoais. A interferência do outro no controlo sobre os nossos
recursos. A entreajuda.
o
Discussion in plenary

Contar sem ordem – a necessidade de cumplicidade para a emergência da ordem. A resistência à frustração.
A emergência dos papéis no grupo.

Cama de balões – A confiança nos outros. Dar suporte a partir de elementos frágeis. Conjugação de esforços –
a ajuda não é dada só por uma pessoa. Tem de haver outras pessoas a apoiar esse suporte.
o
Discussion in plenary
Theoretical presentations and discussion in plenary

Workplace psychosocial risks
o
Stress
o
Burnout
o
Violence
o
Moral siege (?)

Why are Workplace psychosocial risks a problem?

Why we should address possible Workplace psychosocial risks?
o
Economic reasons
o
Ethical reasons
o
Legal reasons
Prevention of stress strategies in PwID service providers and multidisciplinary teams
a)
b)
Role Playing

Equipa com Problemas – A interferência das questões pessoais na boa dinâmica da equipa. Tolerar.
Compensar. Compreender para evitar activar a reactividade dos outros.
o
Discussion in plenary

Dominó – A gestão de recursos e necessidades. A (in)formalidade das regras. Integrar ou marginalizar.
Construir as regras de jogo ou jogar a partir das regras de alguém. Respeitar ou adaptar.
o
Discussion in Plenary
Theoretical presentations and discussion in plenary

Different intervention levels
o
Organizational
o
Interface Individual – Organizational
o
Individual

Care with Confidence
Projecto financiado com o apoio da Comissão Europeia.
A Informação contida nesta publicação (comunicação) vincula exclusivamente o autor, não sendo a Comissão responsável pela utilização que dela
possa ser feita.
Trainees:
The group was composed of 14 professionals. 13 were coming from FENACERCI associates and 1 from an
organization not associate to FENACERCI. Most of them were from Lisbon (12) and 2 came from Alentejo.
CENTRE/NATI
ON (in a word)
Centre
LISBON
LISBON
LISBON
LISBON
LISBON
LISBON
ALENTEJO
ALENTEJO
LISBON
LISBON
LISBON
LISBON
LISBON
LISBON
PARTICIPANT AGE (IN
NAME/CODE YEARS)
SEX/GENDER
: 1=Female,
2=Male
Subject
Sex
ARCA
MCSR
FM
RS
MIB
MFFG
AF
CR
LP
CA
SA
L
TGG
FF
Mean
Age
29
36
23
40
49
30
55
38
50
24
29
57
33
30
37,4
1
1
1
1
1
1
1
1
1
1
1
1
1
1
YEARS OF
EXPERIENCE
(in two
numbers)
Experience
5
14
23
11
27
6
32
13
11
1
6
39
9
6
14,5
PROFESSION (in
words)
WORKPLACE
(indicate how
many
LEVEL OF COURSE
clients/users, in ATTENDANCE: 1=low,
numbers)
2=medium, 3=high
Role
Workplace
PSYCOLOHGIST
SOCIAL SERVICE
SOCIAL SERVICE
TERAPHIST
TERAPHIST
SOCIAL SERVICE
TERAPHIST
PSYCOLOHGIST
FRONT LINE
SOCIAL EDUCATOR
SOCIAL EDUCATOR
FRONT LINE
PSYCOLOHGIST
SOCIAL SERVICE
Attendance
60
30
100
60
60
45
50
50
30
30
15
39
39
50
47
3
3
3
3
3
3
3
3
3
3
3
3
3
3
Table 1 – Lisbon Core Curriculum Training Modules – Trainees Information
The entire group were female (100%), between 24 years old to 57 (in average 37, 4 years old).
Considering work experience the range in this group were from less than one year experience (5 months)
to 39 years experience. The trainee with the highest level of experience was a front line staff member,
which is very usual in these organizations since they started delivering services mainly with front line
services.
Their professions represented in the training were mainly technicians (high degree studies) such as,
psychologists (3), social service workers (4), therapists (3) and social educators (2). Two trainees were
front line staff.
They all work in day care centres or residential units and provide services to 47 clients on average (range
between 15 and 100).
All participants had a high level of course attendance.
Core Curriculum Delivery:
The core curriculum items built on slides produced by the partnership were delivered in Lisbon in a period
of 21 hours, during 3 days: the 6th, 13th and 15th November 2010. This training was composed of 4
different modules as explained above. The distribution of topics was done as follows:
On the first module we’ve included three core curriculum issues, such as:
 Quality of Life in Front Line staff and Service Provide role in the Mental Health Promotion section
 Mental Health and Behaviour Problems in Mental Health Disease and Expression of Mental
Health disease or problems in PwID section
 Vulnerability and Resilience In Particular Issues of ID section
All slides have been delivered before translation to Portuguese.
Projecto financiado com o apoio da Comissão Europeia.
A Informação contida nesta publicação (comunicação) vincula exclusivamente o autor, não sendo a Comissão responsável pela utilização que dela
possa ser feita.
On the third module we’ve included two core curriculum issues, such as:
 Assessment in the Comprehensive Model to reference, assessment and intervention planning in
multidisciplinary team section
 Intervention in the Comprehensive Model to reference, assessment and intervention planning in
multidisciplinary team section
Slides have been delivered before translation to Portuguese. We found particularly difficult to incorporate
and deliver slides number 25 and 26 from regarding Assessment issue, so we have made the decision of
not including those ones in the training modules. Nevertheless, we consider that the matters they address
are of importance to the core curriculum; these topics are included in our training already but delivered in
a slightly different form.
On the fourth module we’ve included one core curriculum issue, such as:
 Stress Management in the Prevention of stress in the workplace section
All slides have been delivered before translation to Portuguese.
Evaluation:
All trainees have filled in the evaluation form 1 before starting the training, so 14 forms have been
collected.
At the end all trainees have filled in the evaluation form 2, so 14 forms have been collected also.
The data will be transferred into the partnership database and will be sent to the coordinator and
promoter.
Photos:
Projecto financiado com o apoio da Comissão Europeia.
A Informação contida nesta publicação (comunicação) vincula exclusivamente o autor, não sendo a Comissão responsável pela utilização que dela
possa ser feita.