—by Matthew K. Weiland and Paul M. Kubek
Columbus, OH—Over 400 people from urban, suburban, and rural communities throughout Ohio, 12 other states, and overseas convened in Columbus on October 2 and 3 for the seventh annual Ohio SAMI CCOE Conference. The event featured two keynote plenary sessions about the future of integrated treatment as well as 36 workshops that addressed a wide variety of topics such as the importance of fidelity reviews, outcomes monitoring, introductory and advanced lessons in core clinical practices of the Integrated Dual Disorder Treatment (IDDT) model, and overviews of other evidence-based practices.
Participants came from these states:
Discussions inspired at this year's event revolved around the conference theme, "Teams Work!", with one of the main attractions being 8 different presentations by various service teams from around Ohio that provide general IDDT services as well as programs tailored for specific populations, including the homeless, multicultural communities, criminal justice and community re-entry clients, and consumers in acute and forensic inpatient settings.
The two-day event was hosted by the Ohio Substance Abuse and Mental Illness Coordinating Center of Excellence (Ohio SAMI CCOE), an initiative of the Center for Evidence-Based Practices (CEBP) at Case Western Reserve University. It became the largest, most comprehensive conference yet. For policy makers, administrators, researchers, and direct-service providers who made the trek, it was not only an experience of education but one of connection as well.
One of the more valuable aspects of the annual Ohio SAMI CCOE conference involves the informal conversations that occur during break times when individuals have a chance to share information, compare experiences, and forge relationships with colleagues that can last for years. We caught up with a few folks during breaks between sessions to get their ideas about the value of IDDT. Below are some highlights from these conversations.
For Patrick E. Boyle, MSSA, LISW, LICDC, director of implementation services at the CEBP and its Ohio SAMI CCOE initiative, this year's conference proved successful beyond expectations.
"It's really inspiring," he said during a break between workshops. "It's also gratifying to hear about the successes that people are having and know we had some part in it, helping people work together to help consumers lead better lives. . . . It's gratifying to know that what we're doing collectively here is making a difference for people."
Boyle explains that the conference is designed to convene a wide range of professionals who have varying amounts of experience and success implementing integrated treatment, with the rookies and the veterans essentially learning from each other. It is also designed not only for participants to get information but to get inspired and, thus, rejuvenated. It is an opportunity to rekindle a sense of optimism, which is one of the core tenets of IDDT. Service providers and stakeholders who are optimistic about the human ability to recover from co-occurring disorders have demonstrated an ability to provide hope to consumers. Through peer networking, the conference reinforces this sense of can-do.
"For me," says Boyle, "that's the biggest bang that comes out of this."
The annual conference, he also notes, is one of several core training and peer-networking services offered by the CEBP and its CCOE initiatives. He points out that professional peer-networking is important because it affords opportunities for support within and across service systems and professional disciplines, helping new and existing service teams avoid common pitfalls, overcome barriers, and capitalize on strategies that work to achieve and sustain positive outcomes. It's a chance to find out what people are doing in the trenches and to see how different folks are handling different challenges.
For some attendees, like Tom Godwin, MA, LCPC, LCADC, newly-appointed as a training specialist to the Evidence-Based Practice Center at the University of Maryland School of Medicine, the conference presented the overall scope of integrated treatment from various perspectives—including the processes of clinical, organizational, and systems change.
Godwin, who is responsible for implementing SAMHSA's IDDT tool kit for the State of Maryland, found the workshops he attended helpful in fully understanding the complexities of integrated treatment. In particular, he noted that he now feels more prepared to anticipate and answer questions that might be asked by state leaders and organizations he advises.
Numerous topics regarding organizational change were addressed from the local perspective during the 8 different panel presentations made by members of Ohio service teams, all of which included open dialogue among presenters and participants. For some, it was an introduction to the integrated treatment model.
For instance, Brenda Freeman, M.D., and cohort Christine Gregor, MSW, LSW, from the Community Treatment Team at Mercy Behavioral Health in Pittsburgh, brought nine staff members to the two-day event to familiarize them with IDDT principles and practices. Presently, their work in Pittsburgh is centered around the closing of a state hospital, helping approximately 200 consumers transition into outpatient, community life. Dr. Freeman and Ms. Gregor's team is now exploring how it might help these consumers sustain independent living in the community with the integrated treatment model.
The workshops that covered clinical change provided important dialogue about the day-to-day work that takes place between direct-service providers and consumers, about navigating the nuances of clinical relationships with approaches like stages of change, stage-wise treatment, motivational interviewing, and cognitive behavioral therapy. Workshops also explored practical methods for service providers to work with other service team members to stay focused on each client's expressed goals for recovery.
For participants like Scott Gatton, MSSA, LISW, of Mount Vernon, Ohio, the conference offered occasion for reflection. During the full-day "Dual Diagnosis Assessment" workshop, for example, he had the opportunity to think about several difficult cases back home and to take away a few new methods for assessing those consumers.
"There are not too many times in my professional day when I can just sit down and think about what I am doing," he said. "And that was very beneficial."
One of the presenters, psychiatrist Justin Trevino, M.D., noted after his presentation how IDDT is an evolving service approach and the more dialogue that occurs among service providers, administrators, and policy makers—especially those from diverse backgrounds and settings—the more learning and enrichment is gained.
As noted by Dr. Trevino, connecting and conversing with others of like-mind is essential because it is inspirational and educational. Yet, the initial decision to do this work and the ongoing day-to-day decisions to continue doing this work is ultimately personal.
"It becomes what I do," says Dr. Trevino, referring to integrated treatment. "It should pervade everything we do with all the patients we see. And actually, a lot of [IDDT] philosophies I try to incorporate in my life—being attentive and listening, kind and caring, trying to understand where people are coming from and trying to problem-solve from someone else's perspective . . . . I don't know if it's a way of life, but I've tried to incorporate it into my life beyond professional practice."
Increasing Access to Quality Care
One of the main purposes of the annual conference is to advance the Ohio Department of Mental Health's (ODMH) goals of increasing the quality of care and access to quality care for Ohio residents.
According to Lon Herman, MA, chief of clinical best practices at ODMH, the conference helps maintain and enhance quality by extending the latest in service innovations to organizations represented at the event and by exposing them to new ideas about how to improve the integrated treatment model. Herman noted that he saw a number of familiar faces from around the state at the event, notably policy makers from county boards and executives from organizations—some of whom are already utilizing IDDT and some who are in the process of determining whether or not to pursue implementation.
"There are those who are more in a pre-contemplative stage," Herman said, noting that the information and networks of colleagues at the event could persuade them to the contemplation or even preparation stage of organizational change. "There are a lot of decision makers here who can really move forward, therefore, really increasing access [to IDDT in communities throughout the state]."
The Center for Evidence-Based Practices (CEBP) and its Ohio SAMI CCOE initiative would like to thank the following Ohio IDDT team presenters for the experiences they shared about implementing integrated treatment in rural communities, small towns, and large cities:
- Central Ohio Mental Health Center (COMHC) of Delaware and Morrow Counties
- Crisis Intervention of Stark County
- Mental Health Services, Inc. of Cuyahoga County
- Neighboring of Lake County
- Ohio State Hospitals/BHOs
- Scioto Paint Valley Mental Health Center of Highland and Fayette Counties
- South Community, Inc. of Montgomery County
- The Nord Center
- Ohio SAMI CCOE initiative of the Center for Evidence-Based Practices (CEBP) at Case Western Reserve University (a partnership between the Mandel School of Applied Social Sciences and the Department of Psychiatry, Case School of Medicine)
- Ohio Department of Mental Health (ODMH)
- Ohio Department of Alcohol and Drug Addiction Services (ODADAS)
- Cuyahoga County Alcohol and Drug Addiction Services Board
- Center for Substance Abuse and Mental Illness at the Mandel School of Applied Social Sciences, Case Western Reserve University