Enhancing concurrent capability: A toolkit for managers and staff Comprehensive interventions Contents Introduction ........................................................................ 5 Comprehensive interventions ............................................. 10 Clinical decision making: Comprehensive interventions ...... 12 The standard approach to concurrent capable practice ....... 13 Comprehensive interventions: An integral part of your practice...................................................................... 15 Engaging individuals and families to choose interventions ...................................................................... 16 Intervention factors and formats......................................... 23 Approaches and interventions ............................................ 30 Successful engagement and selection of comprehensive interventions ...................................................................... 62 Menu board of interventions and approaches .................... 64 Conclusion ......................................................................... 66 Appendices ........................................................................ 69 References .......................................................................... 79 Addiction & Mental Health Concurrent Capable Practice Supports Updated 2018 Copyright © (2018) Alberta Health Services. 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Enhancing concurrent capability: A toolkit Table of Contents interventions Comprehensive Introduction ........................................................................................................... 5 How was this toolkit chapter created? ...................................................................... 5 What you will learn in this chapter ........................................................................... 7 Terms and definitions ............................................................................................... 8 Comprehensive interventions ............................................................................ 10 What are comprehensive interventions? ................................................................. 10 Key messages ......................................................................................................... 10 Comprehensive interventions and Alberta Health Services ...................................... 11 Clinical decision making: Comprehensive interventions ................................. 12 Clinical decision-making process ............................................................................. 12 The standard approach to concurrent capable practice .................................. 13 Comprehensive interventions: An integral part of your practice ................... 15 Engaging individuals and families to choose interventions ........................... 16 Therapeutic alliance ................................................................................................ 17 Recovery oriented care ........................................................................................... 17 Review: Understanding stages of change and stages of treatment ......................... 22 Intervention factors and formats....................................................................... 23 Setting .................................................................................................................... 23 Environment or milieu ............................................................................................ 24 Duration and amount of intervention ..................................................................... 25 Timing and use of interventions ............................................................................. 25 Individual or group interventions ............................................................................ 25 Overview ................................................................................................................ 29 Approaches and interventions ........................................................................... 30 Approaches ............................................................................................................ 30 Exercises: Approach ................................................................................................ 40 Interventions .......................................................................................................... 42 Exercises: Intervention ............................................................................................ 58 Evaluation of Interventions ..................................................................................... 59 Successful engagement and selection of comprehensive interventions ....... 60 Menu board of interventions and approaches ................................................. 62 Exercise: Building an ‘Intervention’ Sandwich ......................................................... 63 Key Messages ......................................................................................................... 63 Conclusion ............................................................................................................ 64 — 3 — Enhancing concurrent capability: A toolkit Comprehensive interventions Comprehensive Appendices 1. Ground rules for support groups .................................................................... 67 2. References on treatment options for specific concurrent disorders ...................70 3. Spectrum of types of peer support ................................................................. 71 4. Psychopharmacological resources ................................................................... 72 5. Psychopharmacologic treatment recommendations ....................................... 73 6. Vignettes and examples for exercises.............................................................. 74 References ............................................................................................................ 77 — 4 — Enhancing concurrent capability: A toolkit Introduction interventions Comprehensive How was this toolkit chapter created? The content for this chapter was developed following a literature review and discussions within the organization to establish what resources were available and what needed to be included for Addiction and Mental Health (AMH) related to comprehensive interventions. This chapter is one of eight in the Enhanced Concurrent Capability (ECC) Toolkit. A number of relevant websites were reviewed related to specific addiction and mental health associations and organizations. Content was validated with a variety of stakeholders who were part of a provincial working group and AMH clinical network. Representation on these committees was inclusive of the various zones and sectors representing Addiction and Mental Health in Alberta Health Services. We would like to acknowledge the work of the participants who helped create this resource and are grateful for their valuable contributions. We are committed to matching the toolkit content to the needs of the people who will be using it. We welcome any feedback, questions, or suggestions for content additions or revisions. We wish to learn from the experiences at the front line, so please let us know how well this toolkit works for you by emailing us at [email protected] — 5 — Enhancing concurrent capability: A toolkit Acknowledgements interventions Comprehensive and special thanks Sponsors North Zone Barry Andres, Executive Director, Provincial Addiction Jamie Terhorst, Clinical Educator, AMH and Mental Health (AMH) South Zone Jill Mitchell, Director, Professional Development and Robert Johnston, Manager, AMH Concurrent Capability, Provincial AMH Tanya Figg, Manager, AMH Reference Group Members Coralee Rahn, Manager, AMH Tracey Labbie, Manager, Concurrent Capable Practice Supports, Provincial AMH Treena Tallow, Coordinator, AMHB, Indigenous Health Program Edmonton Zone Central Zone Daniel Scott, Manager, AMH Deborah Tabin, Manager, AMH Reshawn Heppner-Colville, Counselling Supervisor, AMH Cindy Shyback, Manager, AMH Calgary Zone Provincial Team Kathleen Leslie, Registered Nurse, AMH David Bailey, Provincial Initiatives Consultant, Provincial AMH Robbin Sutherland, Education Consultant, Decision Support Team, AMH Jim Savory, Addictions Senior Advsior, Provincial AMH Dawn Edwards, Education Consultant, Decision Support Jackie Clark, Clinical Consultant, Concurrent