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Community Support Services Training Direct Care Series-Session 6


Learning Objectives. Become familiar with Evidence-Based Practices. Learn strategies and content in Illness Management and Recovery (IMR) and its relationship to CSS. – PowerPoint PPT presentation

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Title: Community Support Services Training Direct Care Series-Session 6

Community Support Services TrainingDirect Care
Series-Session 6
  • Zakia Clay, MSW, LCSW
  • Ann Reilly, MA, LSW, CPRP
  • Anthony Zazzarino, MA, LPC, CPRP

Learning Objectives
  • Become familiar with Evidence-Based Practices
  • Learn strategies and content in Illness
    Management and Recovery (IMR) and its
    relationship to CSS.
  • Demonstrate knowledge of Integrated Dual Disorder
    Treatment (IDDT) best practices for supporting
    individuals with co-occurring disorders
  • Learn/review skills necessary to facilitate a
    structured task group
  • Become familiar with characteristics and skills
    of an effective group facilitator

What makes IMR an evidenced-based practice?
(Pratt, Gill, Barrett Roberts, 2014)
What are Evidence-Based Practices?
  • Integrated Dual Diagnosis Treatment (IDDT)
  • Assertive Community Treatment (ACT)
  • Pharmacologic Treatment
  • Psycho-Education for Families
  • Supported Employment
  • Illness Management and Recovery (IMR)

Illness Management and Recovery(IMR)
  • IMR is an evidence-based practice that helps
    people with mental illness
  • Set meaningful personal goals
  • Acquire skills necessary to cope with and manage
    their illness
  • Make progress toward their recovery

Core Values of IMR
IMR Modules
IMR Group Discussion
  • Thinking of services contained in CSS
  • Thinking of expected outcomes of CSS
  • How do we use the tenets of IMR as an impetus to
    support change?

How does IMR relate to Community Support Services
  • Improved ability to manage ones illness is a
    common recovery goal
  • Avoiding relapses and re-hospitalizations gives
    people greater control over their lives
  • Less time spent dealing with mental illness
    allows more time to be spent on personal recovery
  • Less distress due to symptoms leads to a better
    quality of life
  • Increases independence through skill development

  • Motivational
  • -Convey confidence and hope
  • -Relate learning to goals
  • -Explore pros and cons of change
  • Educational
  • -Active teaching
  • -Multiple methods
  • -Simple, normalizing language

Strategies, contd
  • Cognitive Behavioral
  • Shaping
  • Role Playing
  • Modeling
  • Reinforcement
  • Homework
  • Jointly agreed upon
  • Individualized and goal related
  • Behaviorally specific
  • May involve or be facilitated by others
  • Should be followed up

Anticipated Outcomes
  • Reduce relapses/re-hospitalization
  • Reduced symptom severity
  • Increased knowledge base
  • Increased medication management
  • Improved coping skills
  • Increased hopefulness and optimism
  • Improved social skills
  • Improved collaboration

Small Group Activity
  • Case Vignettes..

Integrated Dual Disorder Treatment (IDDT)
  • The Integrated Dual Disorder Treatment (IDDT)
    model is an evidence-based practice that improves
    the quality of life for people with co-occurring
    severe mental illness and substance use disorders
    by combining substance abuse services with mental
    health services

(Center for Evidence-Based Practices)
Why dual treatment?
  • An estimated 45 of individuals with alcohol use
    disorders had at least one co-occurring
    psychiatric disorder
  • In the National Comorbidity Study, approximately
    78 of alcohol-dependent men and 86 of
    alcohol-dependent women men with criteria for a
    lifetime diagnosis of another psychiatric
    disorder, including drug dependence

(Brady Sinha, 2005)
Negative life outcomes for individuals dually
diagnosed include..
  • Psychiatric episodes
  • Hospitalization and emergency room visits
  • Relationship difficulties
  • Violence
  • Suicide
  • Arrest and incarceration
  • Unemployment
  • Homelessness
  • Poverty
  • Infectious diseases, such as HIV, hepatitis, and
    sexually transmitted diseases
  • Complications resulting from chronic illnesses
    such as diabetes and cancer
  • (Center for Evidence-Based Practices)

Integrated Dual Disorder Treatment (IDDT)
  • Helps people address both disorders at the same
    timein the same service organization by the same
    team of treatment providers
  • Emphasizes that individuals achieve big changes
    like sobriety, symptom management, and an
    increase in independent living
  • Takes a stages-of-change approach to treatment,
    which is individualized to address the unique
    circumstances of each persons life
  • Is multidisciplinary and combines pharmacological
    (medication), psychological, educational, and
    social interventions to address the needs of
    consumers and their family members
  • (Center for Evidence-Based Practices)

Integrated Dual Disorder Treatment (IDDT)
Core treatment components
(Center for Evidence-Based Practices)
Group Activity-Problem Solving
Discussion Questions
  • What is a group?
  • In what situations are you called on to
    facilitate a group?
  • How can you support your staff in their efforts
    to facilitate a group?

What impacts a group?
  • Content- materials brought to group
  • Dynamics-internal issues (interrelationships
    between members)
  • Forces- external issues (time of day, membership,
  • Leadership- attitude, preparedness

Curative Factors in Groups
(Yalom, 1983)
Types of Groups
  • Counseling Groups focus on growth and
  • Psychotherapy Groups focus on
    antecedents/diagnosis/links to present
  • Self-Help Groups peers share, support, and
    learn from each other
  • Task/structured Groups skills learning and
    development (our focus)

Task/Structured Groups
  • Characterized by a central theme
  • Often singular or short-term
  • Include readings, structured exercises and
    practice opportunities (homework)
  • Dont require advanced clinical training
  • Serve a variety of purposes provide information,
    problem solving, teach skills, share ideas,
    provide support
  • NOT therapy or counseling groups

Structure of the Group
  • Each group has a lesson plan
  • Plan describes the purpose and direction of the
    group (the what, why, how)
  • Each session addresses a topic based on the plan
  • Group leader is responsible for maintaining focus
    on the groups purpose

Group Planning Process- Forms Discussion
  • Lets take a look at a lesson plan form.
  • Is this plan different, or the same, as you would
    use for meeting with an individual?
  • Can any of these steps be applied to your current
    preparation for meeting with an individual?

Characteristics of a Productive Group
  • There is a focus on the here and now
  • Goals of members are clear and specific
  • Cohesion is high a sense of emotional bonding
    in the group
  • Conflict in the group is recognized and explored
  • Members are willing to make themselves known
  • Trust is increased and there is a sense of safety

  • (Corey, 2002)

The Group Counselor Person and Professional
Group Leadership Skills
Active Listening Questioning
Reflecting Linking
Clarifying Confronting
Summarizing Supporting
Facilitating Blocking
Empathizing Evaluating
Interpreting Terminating
Round Exercise
  • Brady, K.T., Sinha, R. (2005). Co-occurring
    mental and substance use disorders The
    neurobiological effects of chronic stress. The
    American Journal of Psychiatry, 162(8),
  • Center for Evidence-Based Practices (CEBP) at
    Case Western Reserve University.(n.d.). Center
    for Evidence-Based Practices (CEBP) at Case
    Western Reserve University. Retrieved April 28,
    2014, from http//
  • Corey, M.S., Corey, G. (2002). Groups process
    and practice. Pacific
  • Grove, CA. Wadsworth Group.

  • Jacobs, E. E., Masson, R.L., Harvill, R.L.,
    Schimmel, C.J. (2009). Group counseling
    strategies and skills. (7th ed.) Belmont, CA
  • Pratt, C. W., Gill, K. J., N.M, Roberts, M. M.
    (2014). Psychiatric Rehabilitation. (3rd ed.)
    San Diego, CA Elsevier Inc.
  • Yalom, Irvin D. (1983). Inpatient Group
    Psychotherapy. Basic Books, NY.
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