Leading in Evidence-Based Co-Occurring Treatment. A Comprehensive System of Care Meeting All SAMHSA Best Practice Measures

Transcription

1 Leading in Evidence-Based Co-Occurring Treatment A Comprehensive System of Care Meeting All SAMHSA Best Practice Measures

2 DID YOU KNOW... The Substance Abuse and Mental Health Services Administration (SAMHSA) has conducted extensive research to determine which treatment model works best for people with co-occurring issues of mental illness and substance abuse. SAMHSA s findings: Integrated Dual Disorder Treatment (IDDT) works best of all current treatment approaches. IDDT is SAMHSA s designated evidence-based model. What is IDDT? IDDT stands for Integrated Dual Disorder Treatment. IDDT teams are unique among co-occurring programs for at least three reasons: 1) They focus on helping people return to vocational, educational and family roles as a core source for recovery; 2) They are interdisciplinary teams, in which all the work is integrated in a whole-person approach; and 3) They are mobile and outreach-oriented, conducting much of their work outside clinical settings. Prakash Ellenhorn is a national leader in using evidence-based IDDT as the sole model for our co-occurring disorders program. Prakash Ellenhorn meets and often exceeds SAMHSA best practice measures. Prakash Ellenhorn delivers care through high-intensity multidisciplinary outreach teams that collaboratively provide integrated substance abuse, medical, mental health, family and psychosocial care from one source, outside institutional settings. Our teams use non-confrontational therapeutic approaches to substance abuse, while actively helping people pursue vocational, educational and familial goals. Why does an integrated treatment approach work? All too often, programs described as evidence-based offer techniques or interventions on a piecemeal basis, supplementing psychiatric work with a substance abuse add-on; or adding a mental health component to substance abuse work. Yet evidence shows that this piecemeal approach has little effect. Real co-occurring work takes as its premise that the two issues of substance abuse and psychiatric disturbance cannot be separated from one another. As parts of a single complex syndrome, both problems must be treated simultaneously, using an integrated approach. This means that co-occurring treatment is not simply a matter of using the right technique. It requires a particular system of care, one that balances the two issues at once. IDDT is just this kind of system of care. But IDDT is also much more than a way to combine substance abuse and mental health treatments. It is a whole-person approach, viewing every individual as distinct, and seeing behavioral challenges as emerging from complex and unique tangles of roots. That is why Prakash Ellenhorn s teams are populated with professionals carrying diverse expertise. Why does focusing on work, school and family facilitate good outcomes? Prakash Ellenhorn s IDDT teams support clients in getting back on a life track whether returning to school, finding employment, or engaging in healthy relationships with their families. Working closely with clients to create meaningful futures fosters real human connection and promotes a sense of hope, while profoundly addressing substance abuse, mental health and psychosocial recovery.

3 Too often, programs focus most of their efforts on helping people understand how to recover, rather than helping them see why they should. Along with family and social connections, work and school are the why. They offer hope, a belief in one s own future, and a path towards success. For years, community mental health programs have endorsed this view, seeing psychosocial recovery not only as a behavioral target, but also as the means to help people recover. Decades of research on psychiatric outcomes support this approach. Repeatedly, addiction research shows that a sense of purpose and meaning are intricately entwined with addiction recovery. When a person can see a road ahead, one in which he or she has a meaningful role in society, that person has a reason to be sober beyond sobriety itself. From day one, Prakash Ellenhorn s IDDT teams keep each client s future front and center, by simultaneously helping clients pursue career, education and familial goals as they are receiving treatment. At Prakash Ellenhorn, we do not view moving ahead with one s life as conditional upon abstinence from substances as if it is a reward or the result of passing a test. Rather, getting on a life track is a major component of achieving sobriety. It is amazing that many programs claiming to provide care that is individualized, integrated, and geared to the whole person, rarely address the social experiences of the people they serve. At Prakash Ellenhorn, we believe you can t provide integrative care without focusing on integrating people back into their social roles, and that a whole person approach misses a central part of the whole, if it does not focus on individuals as social beings. This is why we target work, school and family roles as treatment goals, and why we conduct so much of our interventions hands-on, outside the office and in the community. Why does a mobile community-based approach work? IDDT is the only evidence-based treatment model for co-occurring disorders that works with people while they live in the community. That means people receive IDDT right where their challenges are, while also developing a sense of competency and confidence in dealing with those challenges, pride in what they have achieved, and a motivating life-direction. Consider this irony: In the United States, we spend significant resources on temporary ways to help people, provided in artificial surroundings that remove people from life challenges. But we spend minimal resources on supporting these people when they leave institutional care (whether a hospital or residential setting) and must face the challenges of real life. Prakash Ellenhorn s IDDT teams step into the gap, providing flexible levels of support so people with co-occurring issues learn to deal successfully with the stresses of life, thereby forming the foundation of lifetime recovery. Treatment in the community not only helps people meet their challenges, it also enables them to find sustainable natural supports for sobriety. There is mounting evidence that recovery from addiction happens when people mend and form connections to people and to their community and when they develop a sense of purpose. These resources are only temporarily provided within institutional settings. They are readily available in the community. The Prakash Ellenhorn treatment approach for co-occurring disorders is guided by this core belief: Being engaged in meaningful relationships and having a sense of a future are powerful determinants in a person s desire to recover. Hope and connection are our targets. Scientific evidence supports the success of IDDT A well-known experiment on addiction that came to be called Rat Park challenges traditional ideas about the nature of addiction and its best treatment. The original laboratory experiments on drug addiction placed single rats in individual cages. Each rat received two water bottles, one plain, one laced with heroin. Every rat preferred the drug water, and quickly became addicted. One hundred percent of the rats overdosed and died. However, in a follow-up experiment, many rats were placed together in one cage. Now the rats had cheese, tunnels, friends a whole rat park that offered plenty of things to do and social connections. In stark contrast to the solitary rats, these rats preferred the plain water. Zero percent overdosed on the heroin water. This suggested that when rats led happy, connected lives, their cravings for drugs decreased. Clinical observations and experiments with human beings show similar findings. People who have bonds with other people and the larger society are less likely to become addicted to substances. ADDICTION AS A PROBLEM OF ATTACHMENT, MEANING AND PURPOSE: The science shows that addiction is not strictly a biological phenomenon of chemical hooks in the brain. It occurs when a human s natural need to bond and have meaningful experiences is thwarted. When meaning, purpose and connection are out of reach, people will bond with anything to seek relief including harmful substances. Science demonstrates that disconnection is a major driver of addiction. When people develop healthy attachments with others and reconnect with society, they are less driven to abuse substances.

4 Prakash Ellenhorn is fully aligned with SAMHSA criteria for IDDT work. Prakash Ellenhorn often exceeds the SAMHSA evidence-based criteria. Many of our practices are not the norm today in co-occurring programs. Don t be fooled: scientific research has shown repeatedly and conclusively that a co-occurring program must follow these measures to be effective. Prakash Ellenhorn implements SAMHSA s proven best practices for co-occurring treatment and recovery. A multidisciplinary team works collaboratively on mental health, substance abuse and psychosocial issues. Prakash Ellenhorn provides a wide range of multidisciplinary services to clients, including psychiatry, nursing, multiple office-based treatments, substance abuse treatment, mind/body practices, vocational/educational support and counseling, and personal training. We take a whole-person approach, regarding co-occurring issues as part of a unique and complex individual s struggle with the world. That is why we mold treatment around each person. A psychiatrist is a member of the team and intensively involved in treatment. Psychiatrists must be willing to prescribe psychiatric medications despite active substance use. Robust psychiatric care is integrated into our treatment approach for dual disorders. Our psychiatrists are leading members of our teams, involved in all treatment planning, and carrying small caseloads in order to guarantee time for team involvement. We are willing to prescribe pharmacological medication despite substance use, when appropriate. Clients have access to comprehensive services, including those that reconnect them to employment, school and social activities. These promote connections and help the person move toward a meaningful future. We use an outreach-oriented integration of treatment, with special emphasis on reintegration into school and work, and the development of social connections. Up to 70 percent of our teams contacts with clients is outside the office, for example, attending classes with clients or meeting during a lunch break at work. Clients are not discharged from the program for using. We work with clients even if they are currently using substances. Our approach is to meet people where they are, without preconditions. Through an abstinence-based harm reduction outlook, we start helping a client work toward their dreams right away. That fosters empowerment, connection with others, confidence and hope for a good future all elements of psychosocial healing that contribute significantly to their eventual recovery. All interactions with clients are collaborative and motivation-focused. Trained in Motivational Interviewing, our clinicians build a non-confrontational and partnering relationship with clients, in which clients are respected as the agents of change. We see positive outcomes when our clients feel safe enough to talk about their use in a non-judgmental atmosphere. Prakash Ellenhorn s IDDT team members develop authentic relationships with clients, using this relationship to work through the ambivalence clients feel about giving up something that is meeting primary needs. With the client s permission, specialists involve the family and/or other supporters in treatment. We know that a person s relationships with those around them are a vital component of their wish and ability to change. For this reason, we provide intensive, ongoing support and training to families of people with co-occurring disorders so they can help promote their loved one s recovery. Evidence-based Integrated Dual Disorder Treatment is shown to work better than any other approach for co-occurring issues. Prakash Ellenhorn is at the forefront of co-occurring work in our comprehensive implementation of IDDT. The recovery of our clients with co-occurring disorder is additional evidence of its unique effectiveness. To learn more about Prakash Ellenhorn s highly effective co-occurring treatment program, please info@prakashellenhorn.com or call us at

5 We enhance each client s potential for recovery by treating their psychiatric issues, substance abuse and psychosocial damage simultaneously. Prakash Ellenhorn provides robust psychiatric care in addition to the right supports to promote sobriety, while keeping our eyes focused on community re-integration and self-sufficiency. Ross Ellenhorn, PhD Co-founder, Prakash Ellenhorn, LLC Leading in Evidence-Based Co-Occurring Treatment A Comprehensive System of Care Meeting All SAMHSA Best Practice Measures PRAKASH ELLENHORN, LLC 406 Massachusetts Avenue Arlington, MA Phone: