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
Susan Essock, Ph.D.
Director
Nancy Covell, Ph.D.
Project Director,
Focus on Integrated Treatment
Paul Margolies, Ph.D.
Associate Director
Implementation
Dan Herman, Ph.D.
Director,
ACT Institute
Carlos Jackson, Ph.D.
Associate Director
Operations
What we do?
On-line
training
Distance
Learning
www.practiceinnovations.org
Web-based
Collaborations
Building best practices with you.
Focus on Integrated Treatment
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.
Receive treatment
whether you walk into
an OMH-licensed or
OASAS-certified
program.
No Wrong Door
What does integrated treatment for
COD include?
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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, 469-476.
Integrated Treatment is Effective!
People achieve
abstinence or really cut
down on substance use
They get jobs
They get their own
apartments or homes
They make friends
with people who
don’t use
substances
Their mental health
symptoms improve
and they are happier
with life overall.
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.
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
No cancelled trainings
(e.g., for weather )
resulting in lost resources
Travel costs are eliminated
Advantages to Distance Learning
Log in and
complete modules
when convenient
New staff trained
immediately and
consistently
Re-review
modules
any time
35 Modules by December 2010
Recovery
Stories
Interactive
Exercises
Video Skill
Demonstrations
22 Modules Now Available!
Motivational
Interviewing
Cognitivebehavioral
therapy
Stage-wise
Treatment
Screening &
Assessment
Peer
Recovery
supports
Individual
collaborative
treatment
Supervision
Leadership
Capability &
Fidelity
Distance Implementation Supports
for Practitioners, Supervisors, and Agency Leaders
Monthly
Webinars
Discussion
threads
on LMS
Monthly
Calls
Ask an
Expert
on LMS
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
Current Activities and Future Directions
ACT Model
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Interdisciplinary
Community-based
Comprehensive services
24 hour coverage
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 & Philosophy
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Recovery
Individualized
Shared decision-making
Culturally informed
Core Training
• Part One (2 days)
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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