Comprehensive Continuous Integrated Systems of Care Model An

Comprehensive, Continuous, Integrated, Systems of Care Model An Introduction to The CCISC Model Anne Arundel County Co-Occurring Change Agent Group

Introduction The CCISC Model (Comprehensive Continuous Integrated Systems of Care) Is a Model of Best Practice Principles Of Treatment

CCISC Model Developed by Kenneth Minkoff, MD, Clinical Assistant Professor of Psychiatry, Harvard Medical School

CCISC Model For the purpose of improving treatment capacity for individuals with co-occurring psychiatric and substance disorders.

CCISC Model The latest version, complete with a “Train the Trainers Curriculum” was developed in collaboration with Christie A. Cline, MD, MBA, formerly of the New Mexico Department of Health

System Level Change Basic Characteristics

Basic Characteristics Efficient Use of Existing Resources

Basic Characteristics Incorporation of Best Practices

Welcoming!

Stages of Change Prochaska & Di. Clemente

Motivational Enhancement n n n Express Empathy Develop Discrepancy Avoid Argumentation Roll with Resistance Support Self Efficacy

Basic Characteristics Integrated Treatment Philosophy

Principles of CCISC Model # 1 The co-occurrence of A Substance Abuse Disorder and Mental Illness is an expectation, not an exception.

Principle # 2 All Co-occurring Clients are not the same. Treatment must be individualized.

Appropriate Level of Care n n n Addiction or Mental Health Only Dual Diagnosis Capable Dual Diagnosis Enhanced

Four Quadrant Model Minor Mental Illness Mild or no Sub Abuse mi. SD Minor Mental Illness Major Sub Dependence MIsa Major Mental Illness Mild Sub Abuse MISA Major Mental Illness Major Sub Dependence misa

Locus of Care According to Four Quadrant Model

Principle # 3 Successful Treatment is based on empathic, hopeful, integrated and continuing relationships

Principle # 4 Case Management and clinical care must be properly balanced with: • empathic detachment, • opportunities for empowerment and choice, • contracting, • contingent learning.

Principle # 5 When psychiatric and substance disorders coexist, both disorders should be considered primary.

Principle # 6 Both serious mental illness and substance dependence disorders are primary biopsychosocial disorders that can be treated in the context of a “disease and recovery” model.

Phases of Recovery o Acute Stabilization (Detoxification) o Engagement/Motivational Enhancement o Active Treatment/Prolonged Stabilization o Rehabilitation/Recovery (Relapse Prevention)

Principle # 7 There is no one correct approach to individuals with co-occurring disorders.

Principle # 8 Clinical outcomes for client with co-occurring disorders must also be individualized.