1. PRINCIPLES - CONSIDERATIONS Robert Neri, LMHC, CAP Senior Vice President/Chief Clinical Officer WestCare Foundation, Inc.

2. PRINCIPLES - CONSIDERATIONS A Brief History Lesson InRecovery

3. PRINCIPLES - CONSIDERATIONS Learning Objectives / Topics covered will be: 1.Examples of Co-occurring Conditions 2.Co-Occurring Complicating Issues 3.Identify Recovery Factors 4.Intervention Strategies 5.Risk Considerations with Overdose and Suicide Prevention 6.Identifying High-Risk Situations

4. Substance Abuse/Mental Health are Treatable Diseases/Disorders PRINCIPLES - CONSIDERATIONS

5. Substance Abuse is a preventable behavior is a preventable behavior Addiction Addiction is a treatable disease is a treatable disease

6. PRINCIPLES - CONSIDERATIONS Good Mental Health is the Early Attention to Crisis

7. PRINCIPLES - CONSIDERATIONS Co-Occurring Disorders are the Rule…Not the Exception

8. PRINCIPLES - CONSIDERATIONS Some Examples of Co-Occurring: Substance Abuse/Mental Health HIV or Multiple Chronic Conditions Learning Disabilities Anxiety, Depression, PTSD, TBI

9. PRINCIPLES - CONSIDERATIONS C omplicating I ssues: Arrested Development (Maturity) Habilitation vs. Rehabilitation Criminality (Crime Before Drugs) Social Skill Deprivation Treatment Retention & Medical Adherence

10. PRINCIPLES - CONSIDERATIONS C omplicating I ssues: (continued) Youthful 18 – 26 Corrective Thinking Stigma

11. PRINCIPLES - CONSIDERATIONS R ecovery F actors: Integrated Care Dosage – Length of Stay Therapeutic Alliance Evidence Based Approach (MI/CBT) Family Support Treatment is Cumulative

12. PRINCIPLES - CONSIDERATIONS R ecovery F actors: (continued) The Treatment/Public Safety Continuum Aligned

13. PRINCIPLES - CONSIDERATIONS

14. PRINCIPLES – CONSIDERATIONS I ntervention: Pay Attention to Behavior ~ Don’t Diagnose Expectations and Accountability Refer and Assist with Navigating the System

15. PRINCIPLES – CONSIDERATIONS I ntervention: (continued) Refer to Contracting Agencies Managed Care/Medicaid Providers EAP/DCF/VA/DOC Providers

16. PRINCIPLES – CONSIDERATIONS Use Risk Screening Refer Quickly A Word About Overdose and Suicide Prevention

17. PRINCIPLES – CONSIDERATIONS HIGH PAIN HIGH HOPE LOW PAINLOW HOPE

18. PRINCIPLES – CONSIDERATIONS EXTERNAL MOTIVATION EXTERNAL MOTIVATION (Coercion) IS A GOOD THING! External Internal

19. PRINCIPLES – CONSIDERATIONS STILL USE: “Trust and Verify” Understand Relapse is Usually Situational

20. PRINCIPLES – CONSIDERATIONS HIGH RISK SITUATIONS: Relationship Changes Transitional Periods:  Living Situation Changes  Employment Changes  Loss of a Relationship  Health Conditions Changes

21. PRINCIPLES – CONSIDERATIONS Q uestions/ D iscussion Thank You!