Arbour Health System

Required Basic Competencies in

Addiction/Dual Diagnosis

For Adult Clinicians

Approved by Dual Diagnosis Committee -

July 28, 1998

Attitudes:

· Belief that all consumers and their families deserve to be treated with respect and dignity, even when non-compliant, decompensated, or intoxicated.

· Substance use/psychiatric non-compliance are not to be viewed as moral issues.

· Belief that families and friends are valuable collaborators in treatment, and must be approached with welcoming attitudes.

· Belief that mental illness and substance disorders are both chronic, relapsing disorders in which relapses are not failures, but opportunities for learning.

· Comfort with maintaining a treatment relationship when the consumer is not following recommendations.

Values:

· Addiction and mental illness should be viewed as no-fault diseases. No blaming.

· Patients with addiction and dual diagnosis deserve treatment at the same level of intensity as patients with psychiatric disorders.

· Interventions should never be punitive; consequences should be applied consistently and caringly to help the consumer learn from his/her mistakes.

Knowledge:

· Familiarity with integrated conceptual framework, with parallel phases of treatment, and application of disease and recovery model to both

· Knowledge regarding diagnosis, duration, functionality, and disability associated with psychiatric and substance disorders, separately and together

· Familiarity with diagnostic distinctions between abuse and dependence

· Familiarity with processes for simultaneous assessment of two primary disorders

· Familiarity with assessing phase of treatment and treatment readiness

· Awareness of available resources and how to access them utilizing the system care grid

· Awareness of basic rules concerning maintaining needed psychopharmacological regime for serious mental illness in the presence of active substance disorder, and facilitating psychopharmacology assessment as early in the course of treatment as possible

· Familiarity with basic 12-Step concepts and slogans

Skills:

· Ability to consistently display sensitivity to individuals with diverse disorders, characteristics, and cultural backgrounds

· Ability to perform a basic assessment of addiction and dual diagnosis patients, identifying abuse/dependence, phase of treatment, probable primary psychiatric and substance disorders

· Ability to identify intoxication/withdrawal symptoms and make preliminary recommendations regarding level of care

· Ability to identify probably referral resources based on assessment, and facilitate connection to

· appropriate treatment

· Ability to maintain continuity of care as long as necessary, to facilitate patient engaging in needed treatment

· Ability to identify indications for psychopharmacology assessment in substance-disordered and dual-diagnosis patients

· Ability to utilize an AA meeting list book, and assess patient's quality of participation in recovery programming