Integrated Dual Disorders Treatment IDDT Mountain Manor Treatment

IDDT Model • Co-located integrated team treatment for SUD and cooccurring psychiatric disorders •

IDDT – Staged intervention matching Stage of change IDDT intervention approach Focus Pre. Contemplation

Menu of services Primary therapist/case manager Psychiatric evaluation and treatment Buprenorphine + daily supervision

Initial barriers • • • Differences in approach from SUD IOP Patients belonging to

Strengths and successes • Improvements in medication adherence • Enduring institutional affiliation with return

Remaining hurdles and next steps More stagewise differentiation More integration of internal leadership Expand

Slides: 7

Download presentation

Integrated Dual Disorders Treatment (IDDT) Mountain Manor Treatment Center Baltimore

IDDT Model • Co-located integrated team treatment for SUD and cooccurring psychiatric disorders • Aggressive use of psychiatric medications despite active substance use, with careful consideration of SUD vulnerability • Cross-trained COD therapists with additional focus on medication compliance • Use of relapse prevention medications • Continuous engagement despite continued use and/or relapse • Matching treatment expectations and goals with stage of readiness to change.

IDDT – Staged intervention matching Stage of change IDDT intervention approach Focus Pre. Contemplation Relationship, working alliance, practical support, outreach Engagement Contemplation Persuasion and Preparation Action Maintenance Active treatment Motivation enhancement, assessment and feedback, reduce substance use Manage symptoms of both disorders, skills acquisition, emphasis on goals and function Relapse prevention Refinement, wellness, persistence of stable remission

Menu of services Primary therapist/case manager Psychiatric evaluation and treatment Buprenorphine + daily supervision (BBI) if needed Supervised psychiatric medications including injectables • Group substance abuse counseling (OP and IOP) • COD groups • Medications for alcohol and cocaine • •

Initial barriers • • • Differences in approach from SUD IOP Patients belonging to multiple programs Scheduling Team communication Finding best fit staffing

Strengths and successes • Improvements in medication adherence • Enduring institutional affiliation with return after dropout • Support through lapse and relapse with “bouncing back” common • Buprenorphine as contingency for other strategies • IDDT staff as champions for culture change

Remaining hurdles and next steps More stagewise differentiation More integration of internal leadership Expand target population Expand menu of services – Links to vocational, housing, PRP • Family engagement • •