Escalator Jeopardy

Stepped-care has been recommended in the alcohol and other drug field and adopted in a number of service settings, but few research projects have examined this approach.This article aims to describe a pilot trial of stepped-care methods in the treatment of methamphetamine use and depression comorbidity. Design and Methods. An adaptive treatment strategy was developed based on recommendations for stepped-care among methamphetamine users, and incorporating cognitive behaviour therapy/motivational intervention for methamphetamine use and depression.The adaptive treatment strategy was compared with a fixed treatment, comprising an extended integrated cognitive behaviour therapy/motivational intervention treatment. Eighteen participants across two study sites were involved in the trial, and were current users of methamphetamines (at least once weekly) exhibiting at least moderate symptoms of depression (score of 17 or greater on the Beck Depression Inventory II). Results. Treatment delivered via the adaptive treatment (stepped-care) model was associated with improvement in depression and methamphetamine use, however, was not associated with more efficient delivery of psychological treatment to this population relative to the comparison treatment. Discussion and Conclusions. This pilot trial attests to the potential for adaptive treatment strategies to increase the evidence base for stepped-care approaches within the alcohol and other drug field. However, in order for stepped-care treatment in this trial to be delivered efficiently, specific training in the delivery and philosophy of the model is required. [Kay-Lambkin FJ, Baker AL, McKetin R, Lee N. Stepping through treatment: Reflections on an adaptive treatment strategy among methamphetamine users with depression. Drug Alcohol Rev 2010;29;475-482]

Biological Psychiatry, 2004

Archives of Psychiatric Nursing, 2006

2013

At the end of the two (2) seminars, students will learn and understand the following: •The models of treatment used for consumers with Co-Occurring Substance Use and Mental Health (or CO-SU/MH) disorders. •The nine principles of CO-SU/MH treatment, and basic treatment considerations for working with specific CO-SU/MH disorder ‘cohorts’. •The underpinning theoretical principles of Motivational Interviewing (or MI), and Cognitive Behavioural Therapy (or CBT). •The process, phases, and techniques involved in Cognitive-Behavioural Integrated Treatment (or C-BIT) – including practice of techniques in-class. •The fundamental CBT practices used in the skills building treatment component for the consumer’s CO-MH disorders, deficits, and other problems. •The specific C-BIT strategies used in the skills building treatment component for the consumer’s CO-MH disorders, deficits, and other problems. •The fundamental principles and strategies used in the family and/or social networks treatment component for the consumer’s systemic / long-term recovery progression.

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Journal of Drug Issues, 2018

This study examined the acceptability and effectiveness of The Seven Challenges®, a comprehensive substance use counseling program focused on decision making, compared with commonly provided, or “standard,” cognitive-behavioral substance use treatment implemented with a focus on abstinence. Results, based on data from 71 adult drug court clients, indicated higher acceptability of The Seven Challenges than standard cognitive-behavioral treatment as reflected in treatment satisfaction, honesty, and disclosure, as well as perceived impact of treatment. Results also showed that The Seven Challenges was as effective as standard cognitive-behavioral treatment at improving vocational engagement and was more effective at reducing substance use, related problems, and internal mental distress. The Seven Challenges was also effective at reducing criminal activity, whereas clients of the standard cognitive-behavioral treatment appeared to increase criminal activity. These findings strengthen th...

Journal of dual diagnosis, 2018

Comorbid mental health and substance use problems are highly prevalent in substance use treatment settings and generally lead to poorer treatment outcomes. Pathways to Comorbidity Care (PCC) is a multi-modal training program developed to encourage an integrated service approach to improve clinicians' capacity to identify and manage comorbid substance use and mental health outcomes within public drug and alcohol treatment settings. In this paper we describe the concepts underlying the PCC Package and the use of Implementation Science to assess and overcome potential barriers, including clinicians' preferences, knowledge about best practice and professional culture. The training components include didactic seminars, group workshops run by a local clinical champion on relevant subjects such as Motivational Interviewing and Cognitive Behaviour Therapy, individual clinical consultation and feedback with a senior clinical psychologist. The PCC also includes an online portal contai...

Mental Health and Substance Use, 2011

Journal of Social Work Practice in the Addictions, 2018

As a Latino social worker and educator, I have frequently confronted the shortcomings of mainstream institutions and agencies in advancing interventions and treatment approaches for Latino populations. Latinos, and other communities of color, have all too often endured social and health service structures that reflect not the perspectives, experiences, and values of people of Latin American descent, but rather a cultural and linguistic frame better suited for non-Hispanic White populations. As a consequence, many Latino individuals seeking social and behavioral health services experience a lack of cultural congruence and, in turn, struggle to stay engaged with treatment protocols and organizations that simply do not seem to fit. Unfortunately, for Latino clients, this means that they are often viewed as noncompliant or resistant to treatment when, in fact, they are simply responding to communication styles and expectations that are culturally incongruous (Kirmayer, 2012; Marsiglia &...