Addiction Psychiatry Fellowship Rotation Goals & Objectives



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Addiction Psychiatry Fellowship Rotation Goals & Objectives Table of Contents University Neuropsychiatric Institute (UNI) Training Site 2 Inpatient addiction psychiatry rotation.....2 Outpatient addiction psychiatry rotation.. 4 Adolescent consultation service rotation.. 6 University of Utah Medical Center (UUMC) Training Site 9 Consultation- liaison rotation....9 Infectious disease outpatient clinic rotation...11 Assessment & referral services outpatient rotation... 13 UNI & Division of Professional Licensing, Utah Department of Commerce Training Sites 15 Administrative- medical leave licensing board rotation...15 George E. Wahlen Salt Lake City Veterans Affairs Medical Center (VAMC) Training Site 17 Inpatient addiction psychiatry rotation..... 17 Outpatient addiction psychiatry rotation.. 19 Consultation- liaison rotation....21 Valley Mental Health Adolescent Residential Treatment & Education Center (ARTEC) Training Site 24 Consultation- liaison rotation...24 Odyssey House, Inc. Training Site Residential adolescent addiction psychiatry rotation..27 1

University Neuropsychiatric Institute (UNI) Training Site Inpatient Addiction Psychiatry Rotation Goals and Objectives PATIENT CARE Performs in- depth evaluation, initial management and treatment of hospitalized addiction psychiatry patients Effectively treats patients with complicated co- occurring disorders (addiction, psychiatric, and medical problems). Becomes proficient in buprenorphine induction for opioid addiction Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations Manages clinically a predominance of prescription opioid, heroin, benzodiazepine, alcohol, cannabis, and stimulant addiction patients. Co- leads group, individual and family therapies under supervision MEDICAL KNOWLEDGE Learns various methods for inpatient detoxification, stabilization and referral of patients with a variety of addictions and co- occurring psychiatric disorders. Gains exposure to a broad range of psychiatric and addiction diagnoses and co- occurring psychiatric disorders. Develops exceptional knowledge and skill appropriate to his/her level of training in assessing patients on the addiction psychiatry inpatient service Reads extensively and demonstrates knowledge of addiction psychiatric conditions Manages complex co- occurring addiction and psychiatric disorders and any comorbid medical problems 2

PRACTICE- BASED LEARNING AND IMPROVEMENT Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Exhibits medical records that are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families and uses this information in offering recommendations to the referring physician Excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems in addiction psychiatry 3

Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system Outpatient Addiction Psychiatry Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation, initial management and treatment of outpatient addiction psychiatry patients Effectively treats patients with co- occurring disorders (addiction, psychiatric, and medical problems) on an outpatient basis Becomes proficient in buprenorphine induction for opioid addiction Becomes proficient in the outpatient use of pharmacotherapies for opioid, alcohol and nicotine addiction Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and outpatient care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations Manages clinically a predominance of prescription opioid, heroin, benzodiazepine, alcohol, cannabis, and stimulant addiction outpatients. Provides addiction psychotherapy with supervision, including cognitive- behavioral therapy, twelve- step facilitation therapy, and motivational enhancement therapy MEDICAL KNOWLEDGE 4

Learns various methods for outpatient detoxification, stabilization and medical management of patients with a variety of addictions and co- occurring psychiatric disorders Develops expertise in medication- assisted treatment for addiction and substance use disorders Gains exposure to a broad range of psychiatric and addiction diagnoses and co- occurring psychiatric disorders Develops exceptional knowledge and skill appropriate to his/her level of training in assessing patients on an addiction psychiatry outpatient service Learns group and family therapy of addiction and substance use disorders Reads extensively and demonstrates knowledge of addiction psychiatric conditions Manages co- occurring addiction and psychiatric disorders and any comorbid medical problems PRACTICE- BASED LEARNING AND IMPROVEMENT Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Keeps medical records that are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families Exhibits excellent listening skills PROFESSIONALISM Is reliable and punctual 5

Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems in addiction psychiatry Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system Adolescent Consultation Service Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation and recommends initial management and addiction treatment for inpatient adolescent addiction psychiatry patients Effectively recommends treatment for adolescent patients with co- occurring disorders (addiction, psychiatric, and medical problems) Regularly integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to recommend a management plan at appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis for adolescents Functions as an expert clinician and problem solver Provides comprehensive therapeutic and care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams 6

Responds to psychosocial aspects of illness and functional limitations MEDICAL KNOWLEDGE Exhibits exceptional knowledge and skill appropriate to his/her level of training in assessing adolescent patients Does extensive reading and demonstrates knowledge of how addiction psychiatric conditions interact with and impact the management of a variety of non- psychiatric conditions Demonstrates proficiency in co- managing with child and adolescent psychiatrists complex addiction, psychiatric, and medical problems in adolescents PRACTICE- BASED LEARNING AND IMPROVEMENT Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of addiction psychiatry clinical studies and other information on diagnostic and therapeutic effectiveness Uses information technology to manage information and support his or her education Facilitates the teaching of residents, students and other health care professionals INTERPERSONAL AND COMMUNICATION SKILLS Demonstrates compassion, respect and professional integrity when relating to addicted patients and their families, as well as other staff Develops medical records that are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between addicted patients and their families and uses this information in offering recommendations to the consulting physician Demonstrates excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership 7

Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, their families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems Fully evaluates risks, benefits, limitations and costs of available resources Improves systems of care by integration of his/her practice within the larger system 8

University of Utah Medical Center (UUMC) Training Site Consultation- Liaison Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation, initial management and treatment of addiction psychiatric disorders in hospitalized and emergency department patients Effectively recommends treatment for patients with complicated co- occurring disorders (addiction, psychiatric, and medical problems) Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations Recommends management for prescription opioid, heroin, benzodiazepine, alcohol, cannabis, and stimulant addiction Recommends appropriate strategies for pre- transplantation patients with a history of addiction MEDICAL KNOWLEDGE Recommends various methods for inpatient detoxification, stabilization and referral of patients with a variety of addictions and co- occurring psychiatric and medical disorders Gains exposure to a broad range of co- occurring medical, surgical and addiction psychiatric disorders. Develops exceptional knowledge and skill appropriate to his/her level of training in assessing patients on the medical and surgical inpatient services Reads extensively and demonstrates knowledge of addiction psychiatric conditions 9

Recommends management for complex co- occurring addiction and psychiatric disorders with comorbid medical problems PRACTICE- BASED LEARNING AND IMPROVEMENT Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Exhibits medical records that are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families and uses this information in offering recommendations to the referring physician Demonstrates excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE 10

Develops excellent knowledge of practice and delivery systems in addiction psychiatry Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system Infectious Disease Outpatient Clinic Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation, initial management and treatment of addiction psychiatric disorders in outpatient HIV and other infectious disease patients Effectively recommends treatment for patients with complicated co- occurring disorders (addiction, psychiatric, and medical problems) Regularly integrates medical knowledge with clinical data; judicious use of diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and care plans, including patient monitoring and follow- up Uses excellent interview skills and mental status exams Responds to psychosocial aspects of illness and functional limitations Recommends management for prescription opioid, heroin, benzodiazepine, alcohol, cannabis, and stimulant addiction in HIV patients MEDICAL KNOWLEDGE Recommends various methods for detoxification, stabilization and referral of patients with a variety of addictions and co- occurring psychiatric and infectious disease problems Does extensive reading and demonstrates knowledge of how addiction psychiatric conditions interact with and impact the management of infectious disease treatment 11

Demonstrates proficiency in managing complex addiction, psychiatric, and medical problems PRACTICE- BASED LEARNING AND IMPROVEMENT Reviews psychiatric (and general medical) literature to answer questions raised by other team members Applies knowledge of study designs and statistical methods to the appraisal of addiction psychiatry clinical studies and other information on diagnostic and therapeutic effectiveness Uses information technology to manage information and support his or her education Facilitates the teaching of residents, students and other health care professionals INTERPERSONAL AND COMMUNICATION SKILLS Demonstrates compassion, respect and professional integrity when relating to addicted patients and their families, as well as other staff Medical records are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families and uses this information in offering recommendations to the referring physician Demonstrates excellent listening skills PROFESSIONALISM Reliable and punctual Shows integrity, initiative, and leadership Cooperative, promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with patients Demonstrates compassion, sensitivity to and respect for the dignity of patients, families and colleagues as persons including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems 12

Fully evaluates risks, benefits, limitations and costs of available resources Improves system of care by integration of his/her practice within the larger system Assessment And Referral Services Outpatient Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation of outpatient with substance use disorders Effectively refers patients with co- occurring disorders (addiction, psychiatric, and medical problems) on an outpatient basis Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and outpatient care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations Provides addiction psychotherapy with supervision, including motivational enhancement therapy MEDICAL KNOWLEDGE Learns about appropriate referrals for persons who may need detoxification, stabilization and medical management for a variety of addictions and co- occurring psychiatric disorders Gains exposure to a broad range of addiction diagnoses Develops exceptional knowledge and skill appropriate to his/her level of training in assessing patients in a community clinic Reads extensively and demonstrates knowledge of assessment and referral of substance use disorders PRACTICE- BASED LEARNING AND IMPROVEMENT 13

Independently and under the guidance of supervisors, reviews the addiction psychiatric literature to answer questions raised by clinical experiences Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Keeps medical records that are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families Exhibits excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems in addiction psychiatry Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system 14

University of Utah Neuropsychiatric Institute and Division of Professional Licensing, Utah Department of Commerce Administrative- Medical Licensing Board Rotation PATIENT CARE Recognizes addiction psychiatric goals and medical issues related to impaired physicians and provides feedback about monitoring plans and appropriate level of care Understands comprehensive therapeutic and care plans for impaired professionals, including patient monitoring and follow- up Responds to psychosocial aspects of illness and functional limitations MEDICAL KNOWLEDGE Learns about common issues related to professional impairment by addiction and other disorders Does extensive reading and demonstrates knowledge of how addiction psychiatric conditions interact with and impact the function of physicians PRACTICE- BASED LEARNING AND IMPROVEMENT Reviews psychiatric (and general medical) literature to answer questions raised by medical board members Applies knowledge of study designs and statistical methods to the appraisal of addiction psychiatry clinical studies and other information on diagnostic and therapeutic effectiveness Uses information technology to manage information and support his or her education Facilitates the teaching of other health care professionals and board members INTERPERSONAL AND COMMUNICATION SKILLS Demonstrates compassion, respect and professional integrity when relating to monitored physicians and their families, as well as other staff Skillfully observes relevant assessment information and uses this information in offering feedback to the medical board when asked 15

Demonstrates excellent listening skills PROFESSIONALISM Reliable and punctual Shows integrity, initiative, and leadership Is cooperative, promotes teamwork and mutual respect Accepts responsibility for own actions Demonstrates compassion, sensitivity to and respect for the dignity of impaired physicians, including their age, culture, disabilities, ethnicity, gender, and sexual orientation Understands the public nature of monitoring by the medical board, and is respectful of the process SYSTEMS- BASED PRACTICE Excellent knowledge of practice and delivery systems Understands the goals, objectives, and mandates of the medical licensing board Fully evaluates risks, benefits, limitations and costs of available resources Improves system of care by integration of his/her practice within the larger system 16

George E. Wahlen Salt Lake City Veterans Affairs Medical Center (VAMC) Inpatient Addiction Psychiatry Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation, initial management and treatment of hospitalized addiction psychiatry patients Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations Evaluates and follows a variety of patients with many co- occurring disorders, and patients with complex, multiple drug abuse, medical, and mental health conditions Manages clinically a predominance of prescription opioid, heroin, benzodiazepine, alcohol, cannabis, and stimulant addiction patients. Masters the signs of withdrawal and becomes proficient in the treatment of overdose, detoxification, and sobriety maintenance pharmacotherapy for a wide variety of abused substances Develops in- depth experience in the medical and neurological evaluation and management of addicted patients Serves as a group primary therapist, under supervision. MEDICAL KNOWLEDGE Learns various methods for inpatient detoxification, stabilization and referral of patients with a variety of addictions and co- occurring psychiatric disorders. Gains exposure to a broad range of psychiatric and addiction diagnoses and co- occurring psychiatric disorders. 17

Gains exposure to pain management in the addicted population, and treatment of drug abuse in combat or sexual trauma survivors. Develops exceptional knowledge and skill appropriate to his/her level of training in assessing patients on the addiction psychiatry inpatient service Reads extensively and demonstrates knowledge of addiction psychiatric conditions Manages complex co- occurring addiction and psychiatric disorders and any comorbid medical problems PRACTICE- BASED LEARNING AND IMPROVEMENT Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Exhibits medical records that are timely, complete and legible Skillfully obtain relevant assessment information concerning the nature and quality of the relationships between patients and their families and uses this information in offering recommendations to the referring physician Excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients 18

Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems in addiction psychiatry Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system Outpatient Addiction Psychiatry Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation, initial management and treatment of outpatient addiction psychiatry patients Effectively treats patients with co- occurring disorders (addiction, psychiatric, and medical problems) on an outpatient basis Becomes proficient in buprenorphine induction for opioid addiction Becomes proficient in the outpatient use of pharmacotherapies for opioid, alcohol and nicotine addiction Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and outpatient care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations 19

Manages clinically a predominance of prescription opioid, heroin, benzodiazepine, alcohol, cannabis, and stimulant addiction outpatients. Provides addiction psychotherapy with supervision, including cognitive- behavioral therapy, twelve- step facilitation therapy, and motivational enhancement therapy MEDICAL KNOWLEDGE Learns various methods for outpatient detoxification, stabilization and medical management of patients with a variety of addictions and co- occurring psychiatric disorders Develops expertise in medication- assisted treatment for addiction and substance use disorders Gains exposure to a broad range of psychiatric and addiction diagnoses and co- occurring psychiatric disorders Develops exceptional knowledge and skill appropriate to his/her level of training in assessing patients on an addiction psychiatry outpatient service Learns group and family therapy of addiction and substance use disorders Reads extensively and demonstrates knowledge of addiction psychiatric conditions Manages co- occurring addiction and psychiatric disorders and any comorbid medical problems PRACTICE- BASED LEARNING AND IMPROVEMENT Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Keeps medical records that are timely, complete and legible 20

Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families Exhibits excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems in addiction psychiatry Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system Consultation- Liaison Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation, initial management and treatment of addiction psychiatric disorders in hospitalized and emergency department patients Effectively recommends treatment for patients with complicated co- occurring disorders (addiction, psychiatric, and medical problems) Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care 21

Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations Recommends management for prescription opioid, heroin, benzodiazepine, alcohol, cannabis, and stimulant addiction MEDICAL KNOWLEDGE Recommends various methods for inpatient detoxification, stabilization and referral of patients with a variety of addictions and co- occurring psychiatric and medical disorders Gains exposure to a broad range of co- occurring medical, surgical and addiction psychiatric disorders. Develops exceptional knowledge and skill appropriate to his/her level of training in assessing patients on the medical and surgical inpatient and outpatient services Reads extensively and demonstrates knowledge of addiction psychiatric conditions Recommends management for complex co- occurring addiction and psychiatric disorders with comorbid medical problems PRACTICE- BASED LEARNING AND IMPROVEMENT Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS 22

Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Exhibits medical records that are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families and uses this information in offering recommendations to the referring physician Excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems in addiction psychiatry Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system 23

Valley Mental Health Adolescent Residential Treatment and Educational Center (ARTEC) Residential Adolescent Addiction Psychiatry Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation and initial management of adolescents in residential treatment Effectively treats adolescent patients with co- occurring disorders (addiction, psychiatric, and medical problems) in a residential setting Becomes proficient in the use of pharmacotherapies for opioid, alcohol and nicotine addiction and psychiatric disorders in a residential setting Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Provides comprehensive therapeutic and continuing care plans, including patient monitoring and follow- up Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations Manages clinically co- occurring psychiatric disorders, conduct problems, and substance use disorders Provides addiction psychotherapy with supervision, including cognitive- behavioral therapy, twelve- step facilitation therapy, and motivational enhancement therapy MEDICAL KNOWLEDGE Learns various methods for residential detoxification, stabilization and medical management of patients with a variety of addictions and co- occurring psychiatric disorders Develops expertise in medication- assisted treatment for addiction and substance use disorders in adolescents 24

Gains exposure to a broad range of psychiatric and addiction diagnoses and co- occurring psychiatric disorders in adolescents Develops knowledge and skill appropriate to his/her level of training in assessing adolescent patients in a residential setting Learns about adolescent group and family therapy for psychiatric and substance use disorders Reads extensively and demonstrates knowledge of addiction psychiatric conditions Learns about management of co- occurring addiction and psychiatric disorders and comorbid medical problems in adolescents PRACTICE- BASED LEARNING AND IMPROVEMENT Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Keeps medical records that are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families Exhibits excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients 25

Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems in addiction psychiatry Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system 26

Odyssey House, Inc. Residential Adolescent Addiction Psychiatry Rotation Goals and Objectives: PATIENT CARE Performs in depth evaluation and initial management of adolescents in residential treatment Effectively treats adolescent patients with co- occurring disorders (addiction, psychiatric, and medical problems) in a residential setting Integrates medical knowledge with clinical data; judiciously uses diagnostic and therapeutic procedures Prioritizes addiction, mental health and medical goals and issues in order to formulate a management plan at the appropriate level of care Demonstrates excellent ability to generate a differential addiction psychiatry diagnosis Functions as an expert clinician and problem solver Uses excellent interview skills, addiction psychiatry evaluations, and mental status exams Responds to psychosocial aspects of illness and functional limitations Learns about management of clinically co- occurring psychiatric disorders, conduct problems, and substance use disorders Co- leads group psychotherapy with supervision MEDICAL KNOWLEDGE Learns about therapeutic community treatment for adolescent patients with a variety of addictions and co- occurring psychiatric disorders Gains exposure to a broad range of psychiatric and addiction diagnoses and co- occurring psychiatric disorders in adolescents Develops exceptional knowledge and skill appropriate to his/her level of training in assessing adolescent patients in a residential setting Learns group therapy of psychiatric and substance use disorders Reads extensively and demonstrates knowledge of addiction psychiatric conditions Manages co- occurring addiction and psychiatric disorders and any comorbid medical problems PRACTICE- BASED LEARNING AND IMPROVEMENT 27

Independently and under the guidance of supervisors, reviews the addiction psychiatric (and general medical) literature to answer questions raised by clinical care of patients Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness in addiction psychiatry Uses information technology to manage information and support his or her education. Facilitates the teaching of students and other health care professionals. INTERPERSONAL AND COMMUNICATION SKILLS Listens compassionately, with respect and professional integrity to addicted patients and their families, as well as other staff Keeps medical records that are timely, complete and legible Skillfully obtains relevant assessment information concerning the nature and quality of the relationships between patients and their families Exhibits excellent listening skills PROFESSIONALISM Is reliable and punctual Shows integrity, initiative, and leadership Works cooperatively and promotes teamwork and mutual respect Accepts responsibility for own actions Establishes a therapeutic and ethically sound relationship with addicted patients Demonstrates compassion, sensitivity to and respect for the dignity of addicted patients, families and colleagues including their age, culture, disabilities, ethnicity, gender, and sexual orientation Respects patient confidentiality SYSTEMS- BASED PRACTICE Develops excellent knowledge of practice and delivery systems in addiction psychiatry Evaluates risks, benefits, limitations and costs of available addiction psychiatry resources Improves system of care by integration of his/her practice within the larger system 28