Day 3 :
- Workshop session on
Location: Prestwick
Chair
E Renea Snyder
Pennsylvania Department of Corrections, USA
Session Introduction
E Renea Snyder
Pennsylvania Department of Corrections, USA
Title: AOD recovery units in correctional institutions
Biography:
E Renea Snyder is a Drug and Alcohol Program Administrator, Pennsylvania Department of Corrections. She has done Bachelor’s in Psychology and English, a Master’s degree in Education with a Specialization in Curriculum Design and Development, and is currently enrolled as a PhD Psychology student, specializing in Addictions Psychology. She started her career in 2005 with the PA Department of Corrections as Food Service Instructor at SCI-Pine Grove. In 2007, she took a position with SCI-Somerset as a Corrections Counselor and Treatment Specialist. In 2012, she took a position with the Department of Public Welfare, where she had oversight of the Mental Health housing for the Office of Mental Health and Substance Abuse Services. In 2013, she was provided, the opportunity to return to the Department of Corrections, as the Drug and Alcohol Program Administrator. She has worked diligently to bring the AOD Department to current Evidence Based Practices and Programs, by making significant changes to the co-occurring disorders programs, outpatient, and therapeutic communities. She was the lead in making significant changes to the auditing process for the AOD Department and policy revisions. She developed the first Recovery Unit model which is currently being piloted at SCI-Graterford. The model includes progressive treatment modes for the AOD and Corrections field. She has developed training for AOD staff involving clinical supervision and the key components to being an effective AOD counselor.
Abstract:
The Bureau of Treatment Services, Alcohol and other Drug Division for the Pennsylvania Department of Corrections designed an AOD Recovery Unit Model for Correctional Institutions. The AOD Recovery Unit Model is currently being piloted at State Correctional Institution Graterford, in the Eastern Region of Pennsylvania. It is anticipated that the AOD Recovery Unit will decrease AOD relapse once an offender re-enters into the community, as well as the overall recidivism rates of AOD offenders. It is believed that once an offender completes the recommended AOD programming such as Inpatient, Outpatient, or Co-Occurring programs; that the offender will then voluntarily participate in the AOD Recovery Unit. The AOD Recovery Unit offers eighteen workshops and one gender specific workshop. There are eighty-two modules that are gender neutral and 24 modules that are gender specific. The workshops encompass evidence based programs such as SHIELD (Self Help in Eliminating Life Threatening Diseases), SAMHSA’s Intensive Outpatient Matrix, Living in Balance (Hazelden), Natural Meditation, Alcoholics Anonymous, Narcotics Anonymous, Al-Anon, Double Trouble in Recovery and Moving On. There are many self-recovery tools included in the workshops such as; Addictions Journaling, Addictions Art, Addictions Book Club, Beat the Streets Series, and Guided Group topics. The modules are facilitated by Drug and Alcohol Treatment Specialists and trained AOD Peer Assistants. The AOD Recovery Unit at SCI-Graterford is a 115 bed, Outside Secured Housing Unit. Offenders are recommended AOD programming based on the Texas Christian University screening tool. There are currently four levels of AOD treatment provided; Inpatient – Therapeutic Community (4 months), Outpatient (41 sessions), Dual Diagnosis Therapeutic Community (6 months), and Dual Diagnosis Outpatient (47 sessions). Once an offender has completed the recommended programming, they are provided the opportunity to participate in the AOD Recovery Unit. Of those willing to participate in the AOD Recovery Unit, offenders are randomly selected to participate in the AOD Recovery Unit. It is anticipated from this process that AOD Recovery Unit participants will be less likely to relapse upon release into the community. Although we do not have the current numbers available to validate our thesis, we believe this to be a valid Recovery Unit Model and will be able to provide data based on the research at the August conference. We are working closely with our research department and the field staff to ensure efficacy of the model and workshops.
- Special Session on
Location: Prestwick
Chair
Ms. Renee Brown
Next Level Recovery, LLC, USA
Session Introduction
Renee Brown
Next Level Recovery, LLC, USA
Title: Treatment with real life in mind… a model where behavioral science shakes hands with traditional recovery methodologies
Biography:
Renee Brown is President of Next Level Recovery, LLC; Sober Living Properties, LLC; and Smart Medical, LLC. Her past is rich with a diversified outlook on addiction, as she has served as a provider of recovery housing and treatment. She was the first to license a recovery house (Sober Living Properties) in the state of Utah, which is now one of the largest providers of recovery housing in Utah and has programs with behavioral science in the treatment center, Next Level Recovery. Her clients engage in healthy relationships, work or school, and are known to overcome some of their most difficult obstacles in early recovery, before they leave treatment and or recovery housing.
Abstract:
Objective: To introduce a recovery model based on matriculation back into society from the beginning of treatment. To illustrate some of the current draw backs in the traditional model of inpatient care for those who are struggling with substance abuse. To compare and contrast treatment models inside and outside of recovery that entertains the use of behavioral science. To outline some new hope in recovery that might offer more longevity and affordability. Methods: Focus was on executive brain function with an array of goals in recovery housing and treatment – feedback back and accountability in a peer environment and in a clinical environment. Observation and support was needed for immediate positive outcomes, in context to life skills, when a client is still in treatment or recovery housing. Peer accountability, Positive Psychology, CBT, Trauma based therapy, Art therapy, Recreational Therapy and Least restrictive environments are some of the important factors. Results: Connection, social skills, self-regulation, program retention, participation in work or school. Transition from treatment and or recovery housing, was as seamless as possible in context to life skills (family, social, work/school) and sobriety. Affordable resources were provided for continued support.
- Addiction Treatment and Rehabilitation
Yoga and Retreat Approaches
Advanced Research Techniques in Addiction Treatment
Location: Prestwick
Chair
Barry Tolchard
University of New England, Australia
Co-Chair
Adi Jaffe
Alternatives Behavioral Health, LLC, USA
Session Introduction
Jennifer Loftis
Oregon Health & Science University, USA
Title: An “immunomodulatory†approach for the treatment of methamphetamine addiction
Time : 9:50
Biography:
Jennifer Loftis earned a PhD in Behavioral Neuroscience from Oregon Health & Science University (OHSU) and completed a Postdoctoral fellowship in Molecular Microbiology and Immunology at OHSU. In 2008, she was awarded a career development award from the Veterans Health Administration (VHA) to study inflammatory mediators in depression and hepatitis C viral infection (HCV). As a VA career development award recipient she identified a novel role for cytokines in the etiology of depressive symptoms in adults with chronic HCV. This finding has guided the testing of hypotheses regarding how circulating inflammatory factors affect central nervous system functioning and how immunotherapeutic strategies may help to treat these conditions. She is currently a Research Scientist at the VA Portland Health Care System and an Associate Professor of Psychiatry at OHSU, with over 50 publications in the fields of psychiatry, neuroscience, and immunology. To support her translational research program and investigation of the psychoneuroimmunological mechanisms contributing to substance abuse and neuropsychiatric impairments, she has received grants from local and national organizations such as the Northwest Health Foundation, VHA, and the National Institutes of Health.
Abstract:
The role of the immune system in regulating psychiatric and cognitive function, including in the context of substance use disorders, has attracted increasing attention over recent years. Chronic use of methamphetamine (MA), a highly addictive central nervous system (CNS) psychostimulant, is associated with neuronal injury, neuroanatomical alterations, and serious psychiatric and cognitive impairments that make dependence on the substance particularly challenging to treat. Preclinical studies show that MA injures neurons through multiple mechanisms including interfering with dopamine metabolism, altering glutamate processing by astrocytes, worsening oxidative stress, and increasing expression of pro-inflammatory cytokines [e.g., tumor necrosis factor-alpha (TNF-ï¡) and interleukin 1-beta (IL-1ï¢)] secreted from activated glial cells, neurons, auto-reactive T-cells, infiltrating macrophages, or other peripheral immune cells. These findings converge with clinical studies demonstrating the relationship between both peripheral and central inflammatory systems and neuropsychiatric function in individuals addicted to MA. In line with current models of cytokine-induced depression and cognitive dysfunction, MA-associated immune dysregulation can influence neurotransmitter (e.g., dopaminergic, glutamatergic, serotonergic) and neuroendocrine (e.g. corticotropin releasing factor, hypothalamic-pituitary-adrenal axis) systems and contribute to cognitive dysfunction and mood disturbances (e.g., impulsivity, depression, anxiety, and irritability)—neuropsychiatric consequences of drug addiction that persist during remission and hinder recovery efforts. To date, pharmacotherapeutic development for substance use disorders has primarily focused on neurotransmitter systems and results from related clinical trials continue to be modest. Our preclinical data suggest that an immunotherapeutic approach using partial major histocompatibility complex (MHC)/neuroantigen peptide constructs (pMHCs), which have therapeutic effects on cognitive function and inflammation, has the potential to safely and effectively treat MA use disorders in adults. New approaches of this kind are expected to augment the efficacy of traditional substance dependence and mental health treatments.
Adi Jaffe
Alternatives Behavioral Health, LLC, USA
Title: Mobile breathalyzers in substance use disorder treatment: Utilization, validity, and utility in treatment provision
Biography:
Adi Jaffe received his PhD from the University of California, Los Angeles (UCLA) in 2010. Even before he graduated, his name had become known through his online and academic writing. His views on addiction and his research on the topic have been published in dozens of journals and online publications and he has appeared on several television shows and documentaries discussing current topics in addiction and the problem of addiction as a whole. He also teaches courses at UCLA and the California State University in Long Beach that address addiction specifically or biological psychology and behavioral neuroscience more generally. His view is a holistic one, drawing from the best and most recent research to bring as a complete solution to addiction clients. At Alternatives Behavioral Health, LLC, USA, he serves as the Director of Research, education, and innovation and is in charge of client monitoring, technology solutions, and data collections and outcomes research. His goal is to make Alternatives the best treatment program.
Abstract:
Aims: To describe the feasibility, implementation, validity and utilization of mobile momentary-assessment breathalyzers within the context of an intensive outpatient (IOP) treatment for Alcohol Use Disorder (AUD). Methods: Fifty-five participants in an IOP treatment program in Southern California were provided breathalyzers at the onset of treatment. Breathalyzer assessment schedules were set based on client’s self-report of sleep schedule and three to five assessments (M=4) per day were conducted remotely. Breathalyzer data was recorded for the duration of treatment, which lasted between two-to-six months (M=3.5 months). Participants were given a short survey to assess their satisfaction with the breathalyzer system. Data preparation and analysis was conducted using SPSS. Results: Analysis indicated substantial presence of missing data when looking at individual data points. Analysis of relative missing frequency, relative non-zero BAC readings as well as maximum BAC were conducted for the overall sample and based on initial treatment-goal selection. Conclusions: Our study reveals that the utilization of momentary substance detection methods, such as a breathalyzer, within an IOP treatment context is feasible. Furthermore, the study reveals specific analysis recommendations for providers engaged in such data collection. Finally the use of reporting adherence as a measure of treatment progress is suggested given the relationship between treatment success and breathalyzer reporting observance.
Barry Tolchard
University of New England, Australia
Title: Outcome of treatment seeking rural gamblers attending a state-wide cognitive-behaviour therapy service
Biography:
Barry Tolchard has been a clinician and gambling researchers for the past 20 years. He has published work on the outcomes of Cognitive-behavior Therapy for problem gamblers and examined the concomitant health factors associated with gambling. He was one among the team to create a new gambling screening tool (The Victorian gambling Screen) based on public health principles of harm. He is also the co-author of the New England 4G Framework for Guided Self-Health. This framework offers clinicians a model for working with people experiencing a range of mental and physical problems to find solutions to help themselves. He is currently the Deputy Head of School (Health) for research at the University of New England in Australia.
Abstract:
Background: Problem gambling affects many people in Australia and especially rural areas. However, little is reported regarding the differences between the experiences of urban and rural gamblers especially with treatment outcome. The prevalence of problem gambling while stable remains an ongoing issue. There are health and social disparities reported in rural communities related to accessibility, availability, and acceptability of treatments including for problem gamblers. The relationship with problem gambling and co-morbid presentations, in particular anxiety and depression, is well known, 22 although there is little has been reported differentiating between rural and urban gamblers. There is growing evidence to support cognitive-behaviour therapy as the main evidence based treatment for problem gamblers, but until now little research has identified differences between the outcomes of rural verses urban gamblers. Method: A naturalistic examination of the differences between rural and urban gamblers will be presented. All participants were treated in a state-wide Cognitive-Behavioral Therapy (CBT) gambling treatment service in South Australia. A standardised clinical assessment and treatment was provided to all participants. As part of routine clinical outcome measurement a series of validated questionnaires were given to all participants at assessment, discharge and 1-, 3-month follow-up. This is a provisional analysis and as such the number of rural participants was low, therefore a series of descriptive and non-parametric analyses were performed to identify similarities and differences in presentation and outcome of rural gamblers. Results: This study is one of the first investigations to tease out similarities and differences between rural and urban problem gamblers and provides useful guidance on alternative ways of offering treatment. Differences emerged between urban and rural gamblers. While overall treatment outcomes were much the same at three months post-treatment, rural gamblers appear to respond more rapidly and have sustained improvement over time. Female rural gamblers show higher levels of co-morbid anxiety while male rural gamblers experience higher levels of depression compared to urban gamblers. Conclusion: This naturalistic study suggests rural problem gamblers experience different level of co-morbid anxiety and depression from their urban counterparts, but once in treatment appear to respond quicker. CBT is effective in treating rural gamblers and outcomes are maintained. However, ensuring better access and availability of such treatment requires attention. Alternative approaches such as tele-health, internet based therapy and guided self-help may increase the take up of treatments. While also the case with urban gamblers, therapists needs to be aware of the impact specific co-morbidity poses and modifies their interventions accordingly. Limitations: This was a non-randomized study and the number of rural gamblers was small. Therefore further research is required with a larger sample to ensure these outcomes are replicable.
Deanna Mulvihill
Registered Nurse- Multi-State Privilege,USA
Title: The application of rebonding of the body to a substance abuse program
Time : 11:50
Biography:
Deanna is a senior nurse therapist and researcher who have developed a technique called Rebonding of the Body which helps people recover from trauma, learn self-help techniques and lead more productive lives. Her intersubjective ethnographic study has been published in a text called, Women, Trauma and Alcohol Dependency, Connection and Disconnections in Alcohol Treatment for Women. She has published a number of articles in child and family psychiatry including an extensive literature review called “The Health Impact of Childhood Trauma.†Presently Deanna has a small private practice and she works as a consultant for Cogenz and Thought Leadership and Innovation Foundation. Deanna graduated from the University of Western Ontario with Doctor of Philosophy in Nursing in 2009. Her dissertation was “Seeking and Obtaining Help for Alcohol Dependence by Women who have Posttraumatic Stress Disorder and a History of Intimate Partner Violence.
Abstract:
People who have experienced trauma are at a greater risk of physical and mental health problems including PTSD and alcohol and substance abuse. Women with trauma who seek treatment have difficulty benefiting from present programs. Alcohol and other substance used to cope with the symptoms of PTSD and both produce neurohormonal changes in the body. During a 4 month intersubjective ethnographic study in a treatment, it was documented that all women had a history of trauma including the staff, the trauma was documented and discussed during admission meeting but was not considered as part of the treatment plan. Many of the interventions that were part of the program triggered PTSD. Rebonding of the body, a trauma specific multimodality trauma specific program was introduced to a 24 day program to address the underlying trauma issues and provided skills to address triggers.
Ehab Sayed Ramadan
Tanta University, Egypt
Title: Detoxification methods of benzodiazepines mono-dependence: Application and comparison
Time : 13:25
Biography:
Ehab Sayed Ramadan completed MD and PhD from Faculty of Medicine Tanta University, Egypt. He is currently working as a Professor in Psychiatry and Psychology Faculty of Medicine, Tanta University, Egypt. He has sixteen publications in scientific journals. He worked as Director of Neuroscience University Center- Tanta, Egypt, from 9-2008 till 31-6-2010 and Consultant and Head of Neuropsychiatry Department Saudi German Hospital, KSA (from 2000 – 2006). He has experiences in clinical, educational and research work in the fields of psychiatry & psychology at faculties of Medicine, Nursing, and Arts.
Abstract:
Benzodiazepines are among the most common drugs of abuse in Egypt. The severe suffering during withdrawal of benzodiazepines following long term use; magnifies the need to develop treatment strategies for discontinuing these medications. The study aimed to evaluate different detoxification procedures that have been followed to manage benzodiazepines dependence and to assess their efficiency in controlling withdrawal symptoms and relapse rates. This study had been conducted in the center of Psychiatry, Neurology and Neurosurgery, Faculty of Medicine, Tanta University, Egypt. It lasted for 45 days and was divided into three phases; pretreatment phase (7 days), detoxification phase (8 days) and follow-up phase (30 days). Three different methods of detoxification of benzodiazepines dependence were applied during the detoxification phase and included 1) Slow flumazenil infusion (1 mg/500ml saline twice daily) as the main line of treatment with low doses of oxazepam given orally during the first three nights of detoxification phase 2) using oxazepam gradual tapering and 3) abrupt discontinuation of benzodiazepines with symptomatic treatment. Withdrawal symptoms were assessed by psychometric scales BWSQ, HAM-A, HAM-D scores and craving was assessed by VAS scores emerged in the three studied groups during the detoxification phase. The study revealed that flumazenil infusion with low doses of oxazepam was associated with the least intensity of withdrawal symptoms and craving. Also, relapse rates decreased in patients treated with flumazenil than those treated by oxazepam tapering or abrupt discontinuation with symptomatic treatment. It can be concluded that slow flumazenil infusion with low doses of oxazepam appeared to be more effective in controlling withdrawal symptoms, reducing craving and relapse rate after benzodiazepine discontinuation than oxazepam tapering or abrupt discontinuation with symptomatic treatment.
Biography:
Arash Ghodousi, MD is a Forensic medicine specialist, licensed for treatment of addiction from Ministry of Health of IR of Iran. He is working as an Assistant Professor in Islamic Azad University, Isfahan branch, and is the Head of Hashbehesht Private Clinic in Isfahan. He is also a renowned Addiction Therapist.
Abstract:
Today, in Iran, there are various treatments for addicted persons. There are official private and public clinics alongside self-help groups. There also exist compulsory treatment camps under the supervision of police enforcement and judiciary system. Additionally, there are various forms of elicit treatments such as unknown medicine prescription by non medical staff persons. There are some specialized clinics such as alcohol addiction treatment clinics. Different organizations supervise the treatment and rehabilitation such as ministry of health, (State welfare organization of Iran) and (Iran drug control headquarters). Various treatments are done in the supervised clinics such as maintenance therapies with methadone, buprenorphine, opium tincture, psychotherapy and psychiatric therapy, inpatient treatments, rehabilitation and numerous other treatments. Different specialties engage in addiction treatments such as psychiatrists, psychologists, GPs, nurses, and social workers. However state funded medical centers have treatment protocols that need to be followed by each of their medical staffs. In this article, we will review the common addiction treatments practiced in Iran.
Biography:
Prem Kumar Shanmugam is the Chief Executive Driector and Co-Founder of Solace Sabah. He is one of the founding members and Regional Director of the Asia Pacific Certification Board (APCB). He also acts as the President of the Psychotherapy and Counselling Association of Singapore while being one of the founding members as well. He is an independent researcher, trainer working with people with issues from all walks of life exposed to multicultural settings. He specializes in developing and evaluating treatment programmes. He is a certified practitioner in the Management of Family Violence Counselling (Ministry of Community Development Youth and Sports Singapore), a Certified Masters Addictions Therapist (APCB Singapore), a Certified Masters Psychotherapist (APACS Singapore) and an Accredited Clinical Supervisor (Australian Counselling Association and Association of Psychotherapists and Counsellors Singapore). He reviews and writes articles and presents results of substance abuse treatment studies around the region. He has co-authored two handbooks for Masters Students on a counselling course and is an active lecturer.
Abstract:
The etiology of addiction is multifactorial and complex. We know that not everyone becomes dependent instantly as the disease takes time to manifest itself. Furthermore there are multifactorial components that lead to and condition this disease mainly, biological, psychological, social and spiritual. All these various components play a specific role in addictions while some serve a bigger purpose as compared to others. Treating this biopsychosociospiritual disease in a residential setting requires a comprehensive approach, which not only addresses these models influencing it but be holistic at the same time. Treatment also needs to meet clients at their level of motivation and extend even upon discharge addressing the situations in society and the environment the person returns to. This paper presents such a programme, Solace Prime, a residential treatment programme for addictions. It is developed based on scientific and evidence-based approaches with all addictions in mind. The programme is built around Prochaska’s Transtheoretical model of change with the spiritual concepts of the 12-step programme at each stage and driven by theories such as Cognitive Behavioural Therapy (CBT) and Rational Emotive Behavioural Theray (REBT) coupled with alternative therapies such as meditation, nutrition and fitness training. This provides the holistic approach needed to treat a biopsychosociospiritual disease. Over the years treating addictions has taken many approaches but not many have looked into the 28-day residential treatment programme. This paper presents Solace Prime, a holistic, scientific and integrated treatment approach, which has the capability to extend treatment even after discharge from residential treatment.
Emily Stevens
Institute for Restoration and Renewal, USA
Title: Integrating Neurotherapy in the Treatment of Addiction
Biography:
Emily Stevens has over 22 years of clinical experience with diverse populations. Her unique background and approach with emerging brain-based research and interventions such as EEG/QEEG, neurofeedback, alpha-stim/CES, BAUD and AVS has provided her with a unique approach to working with clients with a variety of disorders and dual diagnosis. She began working with addiction clients in 1994 with the Peniston Protocol and began developing specialized protocols for individuals with multiple treatment experiences to better address their dual diagnosis needs in treatment. In 1995, she provided the first of several regional brain-based dual-diagnosis trainings for the Council for Alcohol and Drug Abuse and became an active proponent for the need for more dual diagnosis based treatment. She has been an invited speaker at numerous conferences around the country and has presented over 500 seminars in mental health and addiction nationwide. Her research and publications have focused on innovative clinical and brain-based approaches to improve treatment outcomes with depression, anxiety, ADHD and addiction. Emily recently published a chapter on the use of technology in treatment in Clinical Neurotherapy: Application of Techniques for Treatment.
Abstract:
Technology is expanding the ways that we can improve symptoms to treat disorders. By taking the research and information that we have learned from neuroscience and our understanding of disorders, we can apply different technology to improve client functioning. Clients can learn to manage stress, anxiety and blood pressure with a simple biofeedback program that can be provided in treatment and then transferred to home. Specialized brain based non-invasive stimulation technology can be used with clients with anxiety, OCD, depression and addiction to assist with managing their symptoms within 5 minutes or less. This technology is especially helpful and essential for anyone that works with first responders in treatment. Explore specialized software to improve attention and working memory that may be damaged after years of substance use and abuse. These tools can transform a client’s ability to maintain sobriety and improve functioning in their daily lives. Explore which tool has a 77% abstinence rate according to the literature post one year of treatment if applied with the right clinical protocols. As treatment programs continue to expand the services they provide these tools can fit nicely into treatment. This session will explore proper clinical protocol that will provide the long-term changes and success in treatment that clients are looking for.
Biography:
Ken Seeley is an internationally acclaimed interventionist known to millions of people worldwide from the A&E reality TV show, Intervention. Certified as a Board Registered Interventionist, he has worked full-time in the business of recovery and intervention since 1989. He is a regular contributor to CNN, MSNBC, NBC, CBS, Fox, and ABC on the topics of addiction and intervention, and is also the author of Face It and Fix It, a popular book about overcoming the denial that leads to common addictions while bringing guidance to those struggling with addiction.
Abstract:
Treatment alone often fails people. Evidence based statistics prove this over and over again. The 5 year plan breaks down all key components to a success recovery. The five year plan was created after working with judges from drug court programs. This presentation goes in depth to explain how we build a seamless continuum of care morning past a 28 day model.
Renee Brown
Next Level Recovery, LLC, USA
Title: Treatment with real life in mind… a model where behavioral science shakes hands with traditional recovery methodologies
Biography:
Renee Brown is President of Next Level Recovery, LLC; Sober Living Properties, LLC; and Smart Medical, LLC. Her past is rich with a diversified outlook on addiction, as she has served as a provider of recovery housing and treatment. She was the first to license a recovery house (Sober Living Properties) in the state of Utah, which is now one of the largest providers of recovery housing in Utah and has programs with behavioral science in the treatment center, Next Level Recovery. Her clients engage in healthy relationships, work or school, and are known to overcome some of their most difficult obstacles in early recovery, before they leave treatment and or recovery housing.
Abstract:
Objective: To introduce a recovery model based on matriculation back into society from the beginning of treatment. To illustrate some of the current draw backs in the traditional model of inpatient care for those who are struggling with substance abuse. To compare and contrast treatment models inside and outside of recovery that entertains the use of behavioral science. To outline some new hope in recovery that might offer more longevity and affordability. Methods: Focus was on executive brain function with an array of goals in recovery housing and treatment – feedback back and accountability in a peer environment and in a clinical environment. Observation and support was needed for immediate positive outcomes, in context to life skills, when a client is still in treatment or recovery housing. Peer accountability, Positive Psychology, CBT, Trauma based therapy, Art therapy, Recreational Therapy and Least restrictive environments are some of the important factors. Results: Connection, social skills, self-regulation, program retention, participation in work or school. Transition from treatment and or recovery housing, was as seamless as possible in context to life skills (family, social, work/school) and sobriety. Affordable resources were provided for continued support.
E Renea Snyder
Pennsylvania Department of Corrections, USA
Title: AOD recovery units in correctional institutions
Biography:
E Renea Snyder, Med is a Drug and Alcohol Program Administrator, Pennsylvania Department of Corrections. She has done Bachelors in Psychology and English, a Master in Education with a Specialization in Curriculum Design and Development, and is currently enrolled as a PhD Psychology student, specializing in Addictions Psychology. She started her career in 2005 with the PA Department of Corrections as Food Service Instructor at SCI-Pine Grove. In 2007, she took a position with SCI-Somerset as a Corrections Counselor and Treatment Specialist. In 2012, she took a position with the Department of Public Welfare, where she had oversight of the Mental Health housing for the Office of Mental Health and Substance Abuse Services. In 2013, she was provided, the opportunity to return to the Department of Corrections, as the Drug and Alcohol Program Administrator. She has worked diligently to bring the AOD Department to current Evidence Based Practices and Programs, by making significant changes to the Co-Occurring Disorders programs, Outpatient, and Therapeutic Communities. She was the lead in making significant changes to the auditing process for the AOD Department and policy revisions. She developed the first Recovery Unit model which is currently being piloted at SCI-Graterford. The model includes progressive treatment modes for the AOD and Corrections field. She has developed training for AOD staff involving clinical supervision and the key components to being an effective AOD counselor.
Abstract:
The Bureau of Treatment Services, Alcohol and other Drug Division for the Pennsylvania Department of Corrections designed an AOD Recovery Unit Model for Correctional Institutions. The AOD Recovery Unit Model is currently being piloted at State Correctional Institution Graterford, in the Eastern Region of Pennsylvania. It is anticipated that the AOD Recovery Unit will decrease AOD relapse once an offender re-enters into the community, as well as the overall recidivism rates of AOD offenders. It is believed that once an offender completes the recommended AOD programming such as Inpatient, Outpatient, or Co-Occurring programs; that the offender will then voluntarily participate in the AOD Recovery Unit. The AOD Recovery Unit offers eighteen workshops and one gender specific workshop. There are eighty-two modules that are gender neutral and 24 modules that are gender specific. The workshops encompass evidence based programs such as SHIELD (Self Help in Eliminating Life Threatening Diseases), SAMHSA’s Intensive Outpatient Matrix, Living in Balance (Hazelden), Natural Meditation, Alcoholics Anonymous, Narcotics Anonymous, Al-Anon, Double Trouble in Recovery and Moving On. There are many self-recovery tools included in the workshops such as; Addictions Journaling, Addictions Art, Addictions Book Club, Beat the Streets Series, and Guided Group topics. The modules are facilitated by Drug and Alcohol Treatment Specialists and trained AOD Peer Assistants. The AOD Recovery Unit at SCI-Graterford is a 115 bed, Outside Secured Housing Unit. Offenders are recommended AOD programming based on the Texas Christian University screening tool. There are currently four levels of AOD treatment provided; Inpatient – Therapeutic Community (4 months), Outpatient (41 sessions), Dual Diagnosis Therapeutic Community (6 months), and Dual Diagnosis Outpatient (47 sessions). Once an offender has completed the recommended programming, they are provided the opportunity to participate in the AOD Recovery Unit. Of those willing to participate in the AOD Recovery Unit, offenders are randomly selected to participate in the AOD Recovery Unit. It is anticipated from this process that AOD Recovery Unit participants will be less likely to relapse upon release into the community. Although we do not have the current numbers available to validate our thesis, we believe this to be a valid Recovery Unit Model and will be able to provide data based on the research at the August conference. We are working closely with our research department and the field staff to ensure efficacy of the model and workshops.
Adriana de Oliveira Christoff
Centro Universitário Autônomo do Brasil: Unibrasil
Title: Reducing substance involvement in college students: A three arm parallel group randomized controlled trial of a computer based intervention
Biography:
Adriana de Oliveira Christoff is a Professor at Centro Universitário Autônomo do Brasil: Unibrasil
Abstract:
The prevalence of alcohol and other drug use is high among college students. Reducing their consumption will likely be beneficial for society as a whole. Computer and web-based interventions are promising for providing behaviorally based information. The present study compared the efficacy of three interventions (computerized screening and motivational intervention [ASSIST/MBIc], non-computerized screening and motivational intervention [ASSIST/MBIi] and screening only (control)) in college students in Curitiba, Brazil. A convenience sample of 458 students scored moderate and high risk on the ASSIST. They were then randomized into the three arms of the randomized controlled trial (ASSIST/MBIc, ASSIST/MBIi (interview) and assessment-only (control)) and assessed at baseline and 3 months later. The ASSIST involvement scores decreased at follow-up compared with baseline in the three groups suggesting that any intervention is better than no intervention. For alcohol, the specific involvement scores decreased to a low level of risk in the three groups and the MBIc group showed a positive outcome compared with control and the scores for each question were reduced in the two intervention groups compared to baseline. For tobacco, involvement scores decreased in the three groups but they maintained moderate risk. For marijuana, a small positive effect was observed in the ASSIST/MBIi and control groups. The ASSIST/MBIc may be a good alternative to interview interventions because it is easy to administer, students frequently use such computer-based technologies and individually tailored content can be delivered in the absence of a counselor.
Dalal Akoury
The AWAREmed Health and Wellness Resource Center, USA
Title: Clinical competencies: Topics, gaps and learning objectives and key clinical applications
Biography:
Dr. Dalal Akoury is founder and Medical Director of The AWAREmed Health and Wellness Resource Center, where she directs a team of coaches, nutritionists and nurses who utilize a comprehensive approach to health. She practices, Cellular, Anti-Aging, Functional, Regenerative, Sexual, Cellular and Metabolic Medicine. Her practice Concentrates on Women Health and Rejuvenation, Integrative Addictive treatment, Integrative Cancer treatment, Healthy Aging, Age Management and lifestyle medicine, focusing on customized Facial rejuvenation, nutrition and fitness programs. She is a Fellowship trained and certified in Integrative Cancer Therapy, Anti-Aging, Regenerative, Metabolic and Functional Medicine, and has more than twenty years of accumulated experience in emergency medicine, pediatrics, and a master’s degree in public health. She has also served fellowships in pediatric hematology/oncology and has performed research in leukemia and the effects of smoking at Emory in collaboration with the CDC. Over the past 3 years, she has focused strictly on stress and its effect on aging, sexuality, cancer, and addiction. She has designed the addiction training series offered by the A4M, furthermore she is the founder of the Integrative Addiction Conference and the Integrative Addiction Institute, she has written numerous articles on the topic of addiction and is a well-known advocate and speaker. She Akoury is a Seasoned Media and Community Public Speaker. She is knowledgeable on obesity, fitness, and nutrition, and Sexual Medicine. She is not only a living proof of the benefits of Stress relief, diet and exercise but she is also a medical expert who can guide audiences in understanding the fundamentals behind proper stress relief, nutrition and living well. Her mission is to help change lives.
Abstract:
Learning objectives 1. Emphasize a wholistic approach to understanding the Biologic stress and addiction networks and sub-networks including the Limbic, HPA, HPT, HPG, Serotonergic and Dopaminergic system. 2. Focus on the non-linear interactions between the various components and pathways of stress and addiction to determine the major players in the pathophysiology of cancer and suggested targets of therapy. 3. A “paradigm shift†of molecular biology from a reductionist approach to a more wholistic approach will be highlighted. 4. We will allude to the complex genomics, transcriptomics, epigenomics, and proteomics involved in the neuroendocrine system creating an exceptional self-healing brain circuitry including sub-networks. 5. We will discuss the effect of hypothalamic pituitary adrenal (HPA) axis is deregulation in addiction and cancer. Reflecting on the effect of these HPA imbalances on all the Limbic and HPT circuits and emphasizing the restoration of these circuits as a first step in addiction recovery and cancer treatment. Stress, pain, addiction and the cancer cycle The links between stress, addiction and cancer are multifaceted, spanning from the low incidence of cancer in relaxed happy individuals to altered cancer cell metabolism resulting from unchecked stresses and addictive behaviors. The effect of any form of addictive behavior on cancer development is too obvious to be ignored anymore. Cancer prevention and cure cannot be attained unless stress, addiction, and pain are properly addressed. Cancer is a complex collection of distinct stress induced epigenetic dis-eases united by common hallmarks. In the quest to survive, every living organism is equipped with the armor to withstand the impacts of stress. Every person is equipped to naturally deal with enormous amounts of stress, but when stress exceeds the allostatic body capability to handle it, sizeable imbalances and discomfort result. Contemporary lifestyle is exceptionally infamous for creating continuous stress. This demanding stressful lifestyle creates an environment that cultivates dis-eases progressing from indigestion to insomnia to depression pain, addiction and ultimately cancer. Besides the Physiologic qualitative approach to coping with stress, the nervous system is almost exclusively recognized for the task to maintain homeostasis. The nervous system is a complex networking structure where chemical, electric and energetic reactions occur between billions of individual neurons facilitating large number of behaviors. Stress and Emotion are complex phenomena that play significant roles in the quality of human life and can predispose individuals to a variety of disorders including pain, addiction, and cancer. Many drugs that affect the mind—ranging from sugar, food, addictive street drugs to therapeutic agents—do so by acting on specific neural circuits concerned with emotional states and feelings. The complex System Biology: Limbic, HPA, HPT, HPG, Serotonergic and Dopaminergic system conduct the Symphony of life Survivorship vs environment. The hallmarks of cancer comprise biological capabilities acquired during the multistep development of human tumors. These hallmarks constitute an organizing principle for rationalizing the complexities of neoplastic disease. They include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis. Underlying these hallmarks is genomic instability, which is generated by an epigenetic chaos in most cases stemming from stresses and addictive behaviors. This epigenetic turmoil created by allostatic imbalances; from stress, pain and addictive destructive behaviors generate a cancer prone genetic diversity that accelerates the acquisition and activation of inflammatory cascades that fuel cancer genesis. In addition to cancer epigenetics, cancers exhibit another dimension of complexity: they contain a repertoire of recruited, seemingly normal cells that contribute to the acquisition of trademark traits by creating the “tumor microenvironment.†Recognition of the widespread applicability of these concepts will increasingly affect the development of new means to treat human cancer. This presentation describes a conceptual framework of how addictions contribute to the hallmarks of cancer and how it can be exploited through stress reduction and addictive behaviors reprogramming to restore allostatic balance and energy metabolism evading immune destruction and subsequently selectively kill cancer cells. Finally, we discuss the path ahead to therapeutic discovery and provide theoretical considerations for combining right-angled cancer therapies by addressing stresses and addictive behaviors.
Larry D Reid
Rensselaer Polytechnic Institute, USA
Title: Focusing on cognitive rehabilitation and evidence-based practices will improve treatments for alcoholism
Biography:
Larry D Reid has been a Professor at major universities and centers for more than 47 years. During most of that time, he maintained a small, but continuously funded, laboratory. Among the laboratory’s topics was the behavioral neuroscience of alcoholism, including basic research on opioidergic effects on alcohol intake. A recent interest has been alcoholism among females. The findings from the research on females led to writing a book for smart young women and the people who love them, titled Slowly, Softly Killing Us. Passages of the book are harsh criticisms of the alcohol beverage industries marketing practices.
Abstract:
If we define alcoholism as: “A chronically relapsing disease†we are, in effect, admitting that our treatment programs are inadequate. No one expects 100% of persons treated for alcoholism to emerge transformed from a usually troubled habitual drinker of toxic amounts of ethanol into a happy, flourishing person who does not drink. However, if we attended to what has scientifically been discovered, treatments can be transformed, hence allowing for transformation of our clients. We can continue to hope for some magical, spiritual transformation to finally bring enlightenment to those beset by the disease of alcoholism. Or, we can hope for eventually discovering a medicine fixing the inherent problem of the alcoholic. Or, for the better, we can incorporate recently derived knowledge and step by step design treatments that will make relapse to drinking toxic amounts of ethanol uncommon rather than a definition of a problem needing resolution. I will show that prescribing naltrexone is merely a setting condition for correcting the toxic effects of ethanol on brain that, in turn, has reduced the cognitive ability to make the needed changes in life-styles to support continuing abstinence. Although we used to think that a brain once damaged was not repairable, I will show that he can provide computer-assisted game-like programs that will undue the cognitive decline caused by chronic intoxication thereby enhancing the ability to resist temptations, be less impulsive and develop new life-styles. New knowledge directs us to focus on cognitive rehabilitation for improving treatment outcomes.
Natacha Rodrigues
Middlesex University, UK
Title: Therapeutic treatments from an existential approach and transpersonal psychology theories and practices
Biography:
Natacha Rodrigues Counsellor Psychologist (Hons) BSc, MSc and an Integrative/Humanistic Psychotherapist who also works in an Existential way. Accreditor Mediator and Lecturer for Diplomas in Psychotherapeutic Counselling. Currently she is doing her MSc / Doctorate in Counselling Psychology and Existential Psychotherapy Studies at the Middlesex University. She was born and raised in Lisbon, Portugal. She has lived in South of England – Bournemouth for the last fourteen years where she began her training as an Ericksonian Hypnotherapist, NLP and Life Coaching Practitioner. After completing her training she decided to train as a Humanistic/ Integrative Psychotherapist while working as Counsellor with people in addiction and in bereavement. Meanwhile she trained as a Psychologist at Bournemouth University. During that time she also worked as a Psychologist research assistant - ADHD and Eating Disorders Projects.
Abstract:
My particular interest lies in working with the dilemmas presented by Being-in-the-World-with-Others. How can we negotiate living authentically as individuals alongside other people who are attempting the same task from their own perspective? This question encompasses an issue of identity, addictions and individual’s spiritual connection/disconnection. The workshop will start by giving an overview on existential approach that is first and foremost philosophical. It is concerned with the understanding of people’s position in the world and with the clarification of what it means to them to be alive. This means facing up to ultimate concerns, such as death, guilt, freedom, isolation, meaninglessness, etc. At the time of crises in addictions old patterns need to be revised in order to initiate changes for better. This theme will be discussed from an Existential approach and transpersonal psychology theories; theories that focus on the spiritual dimension and legitimate the development of higher states of consciousness as being part of addiction experiences and as being exceptionally healthy or as representing the epitome of human potential as a tool when in recovery. The approaches are especially suitable for people who feel alienated from the expectations of society or for those seeking to clarify their personal ideology. I will outline the goals of existential therapy and Transpersonal Psychology; Major therapeutic strategies and techniques; The change process in therapy; The task of the Existential therapist/ Transpersonal Psychologist; Themes to explore; Limitations of the approaches. The workshop will end with a brief evaluation of our disconnected culture from a spiritual dimension in treatments.
Biography:
Artemis Igoumenou completed her MD, MSc and PhD from National and Kapodistrian University of Athens in Greece. She completed her psychiatric training in Oxford, UK obtaining a CCT in General Adult Psychiatry and Psychiatry of Addictions. Whilst in Oxford she participated in a number of research projects and collaborated with highly esteemed academics. She became a Clinical Lecturer in Forensic Psychiatry in 2013 at Barts School of Medicine, Queen Mary University London. She is completing her training as Forensic Psychiatrist. She is involved in research and teaching and has strong national and international collaborations. Her main research interest is the relationship between mental disorders and offending. She is currently analyzing neuropsychological data of a large cohort of prisoners in UK and Wales.
Abstract:
In conjunction with publication records, more and more weight is put on citations in determining research productivity by individuals, universities and even nations. This topic is widely discussed and debated within psychiatry but without much empirical evidence to draw on. We felt it was important to examine this issue by analyzing publication output and citations in a range of psychiatry journals. We investigated research productivity and citation practices at both country and university level. We found large differences between and within countries in terms of their research productivity in psychiatry. In addition, the ranking of countries and institutions differed widely by whether productivity was assessed by total research records published, overall citations these received, or citations per paper. We found that most publications came from the USA, with Germany being second and UK third in productivity. USA articles received most citations and the highest citation rate with an average 11.5 citations per article. The UK received the second highest absolute number of citations, but came fourth by citation rate (9.7 citations/article), following the Netherlands (11.4 citations/article) and Canada (9.8 citations/article). Within the USA, Harvard University published most articles and these articles were the most cited, on average 20.0 citations per paper. In Europe, UK institutions published and were cited most often. The Institute of Psychiatry/Kings College London was the leading institution in terms of number of published records and overall citations, while Oxford University had the highest citation rate (18.5 citations/record). The choice of measures of scientific output could be important in determining how research output translates into decisions about resource allocation.