03:00 – 05:00 PM CET
Chairs: Arjen Neven, psychiatrist, Annette Bonebakker, clinical neuropsychologist, Tony Bloemendaal, clinical psychologist – psychotherapist
Welcome and introduction
Annette Bonebakker, clinical neuropsychologist, Fivoor
ADHD and substance use disorder, what have we learned over the past decade of research?
Arnt Schellekens, Professor of Addiction Psychiatry, Radboudumc, the Netherlands
ADHD ans substance use disorders often co-occur and co-occurrence of these conditions has a negative impact on the course of both conditions. Yet, ADHD is still too often overlooked or ignored. An increasing scientific interest in these conditions over the past decade has furthered our understanding of this frequent comorbidity in psychiatry and yielded directions for clinical practice with regard to the diagnostic process and treatment. This lecture will provide an overview of developments in this field over the past decade, including shared heritability, reliability of the diagnostic process and effectiveness of different pharmacotherapies, including high-dose stimulant treatment.
Contingency Management as an effective intervention in Dual Disorders treatment
Geert Dom, Psychiatrist, University of Antwerp, Belgium
Substance use disorders (SUD) are highly prevalent among patients with severe psychiatric disorders and are associated with poorer clinical and functional outcomes. Effective interventions for this clinical population are scarce and challenging. Contingency management (CM) is one of the most evidence-based treatments for SUD’s. Increasingly evidence is growing that CM might be an effective behavioural intervention for patients with these complex co-morbidities. In the presentation we will highlight the current state of CM in different dual disorder populations and present data from a recent meta-analysis of the effect of CM in patients with a dual diagnosis of psychotic disorder and SUD.
Integrated Dual Disorder Treatment: Looking Forward After Twenty Years of Implementation
Patrick Boyle, Consulting Director, Center for Evidence-Based Practices, Case Western Reserve University, USA
Integrated Dual Disorder Treatment (IDDT) was researched and developed during the 1990’s and implemented as an integrated clinical practice to help people with co-occurring mental illness and substance use disorders live full lives in an evolving recovery process (Drake, Goldman, et al 2001). While such evidence based practices have become more widely implemented across the world during the past twenty years, people with these two co-occurring disorders are still at risk of not receiving fully integrated care services for many reasons.
Looking to the future, an ongoing focus, expectation, and effort is required to: 1) rule out substance use disorders for people having mental disorders in all practice settings; 2) recruit, train and supervise all practitioners to properly detect, assess, and treat both disorders in an integrated manner, as well as other co-occurring disorders and conditions such as trauma; 3) support continuous quality improvement strategies in all practice settings to evaluate integrated practice implementation and supervision in an effective and routine manner; 4) make adjustments to services as indicated by such evaluations; 5) fully develop housing, employment, and primary health care systems to support these essential foundations to a full life for all.
Evidence Based Practices clinical interventions needed for full IDDT implementation initially included Motivational Interviewing (and its implied responsibility that all practitioners help people develop the motivation to change), Cognitive Behavioral Treatment, Substance Abuse Treatment (including tobacco cessation), Family educational interventions, Self-help 12-Step support, Pharmacological Treatment for all disorders and practices such as intensive case management, competitive employment, illness self-management recovery and leisure activities, all delivered with a stage-wise person-centered approach to care through multi-disciplinary teams (R. Drake, G. Bond, et al., 2002).
Since the inception of IDDT, additional attention is now necessarily being paid to Trauma Informed Care, using EDMR and numerous psychoeducational interventions, as well as the integration of primary health care.
Essential indicators still relevant for sustaining any EBP implementation include a top-down philosophy of integrated care that appreciates addiction as a condition for intervention vs an issue of willpower, staff education, guidance (supervision) and training, and a routine quality improvement process to measure and monitor a range of relevant client outcomes.
Some organizations continue to seek Integrated Treatment services implementation technical assistance in 2020 as if it were a new system of care. Perhaps it is THEY who are “new”, yet appreciably enthusiastic! Workforce capability and capacity are challenged in some places by practitioner turnover into retirement and movement into other professions due to inadequate financial compensation and psychological support while delivering this array of services with complicated people in need.
The importance of pragmatism, curiosity, self-reflection, and optimism (hope) is essential for success. We are disseminating “hope” for and with people as we continue to add to our knowledge base of integrated disorder treatment implementation.
The registration costs of 75 EUR includes:
- access to virtual live session (accredited) including Q&A module
- access to recording of the webinar for 1 month (not-accredited)
We accept payments by iDeal and credit card (American Express, Mastercard and VISA).
For Dutch participants there will also be request for accreditation at the following associations:
- De Vereniging voor Verslavingsgeneeskunde Nederland (VVGN)
- Verpleegkundig Specialisten Register (VSR)
- Nederlandse Vereniging voor Psychiatrie (NVvP)
- Federatie van Gezondheidszorgpsychologen en Psychotherapeuten (FGzPt)
All participants (also international delegates) will received a certificate of attendance afterwards.
This event is designed for psychiatrists, psychologists, addiction specialist, nurse practitioners, social workers, mental health nurses and all other professionals with interest in the treatment of patients dealing with Dual Disorders.