Addictions Training Program - Treating Substance Dependence and Mental Illness: Tools for Practitioners

Addictions Training Sessions will be open to health practitioners (broadly defined as individuals in training (medicine, nursing, psychiatry, social work, psychology), individuals with current employment within a health-care setting, and/or professional degrees or certification). The objective of the training program is to facilitate the adoption of evidence-based practice in the treatment of clients with addictions and comorbid mental illness by health practitioners. The intended end-users are the physicians, nurses and other health professionals within health care clinics that are likely to encounter drug/alcohol abusers in their daily practice. Below is a brief description of the various modules we will be offering.

NOTE -The six-week training program which usually takes place in the Fall will be conducted in the Spring of 2013. Registration form and syllabus for the course will be updated accordingly.  

Addictions Training Program

Treating Substance Dependence and Mental Illness:

Tools for Practitioners

The 6-session Addictions Training Program will be presented by staff members from the Addictions Unit, McGill University Health Centre (MUHC). The program is open to health practitioners, broadly defined as clinicians currently employed within a health-care setting, with a professional degree or certification (medicine, nursing, psychology, social work, occupational therapy). The objective of the training program is to provide practical tools that will facilitate the detection, screening and assessment of clients with substance use disorders. The sessions are designed to encourage the adoption of evidence-based practices, including very brief interventions. Decision making in relation to treatment planning and referral will be addressed. The sessions will include didactic material, as well as case discussions and practical learning exercises. Film excerpts will be used to demonstrate motivational approaches to screening, and brief interventions in a variety of practice environments. The intended end-users are health care professionals that are likely to encounter drug/alcohol abusers in their daily practice.

Dates:  October 28 to December 9, 2011 (excluding November 11^th). Friday afternoons from 1pm to 4pm (18 hours total)

Location of Sessions:  South Seminar Room, P1.086

Allan Memorial Institute, McGill University Health Centre

1033 Pine Avenue West, Montreal H3A 1A1

Program Information: Contact Dr. Kathryn Gill by fax at 514-934-8262 or email at kathryn [dot] gill [at] muhc [dot] mcgill [dot] ca

Program Registration: Contact Ms. Lyne Marchand at 934-1934 x42066, or by fax at 514-934-8262 or email lyne [dot] marchand [at] muhc [dot] mcgill [dot] ca.

Continuing Education Credits (CME): This event is approved for up to 18 credits by the Centre for Continuing Health Professional Education (CCHPE). The Centre for CCHPE, Faculty of Medicine, McGill University is fully accredited by the Committee on Accreditation of Canadian Medical Schools. This event is an Accredited Group Learning Activity as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada. Through a reciprocal agreement between the American Medical Association and the Royal College of Physicians and Surgeons of Canada, the Centre for CCHPE, Faculty of Medicine, McGill University designates this activity for AMA PRA Category 1 credit(s) up to the maximum of 18 credit hours. Each physician or health professional should claim only those hours of credit that he/she actually spent at the educational activity. In order to receive a certificate from the CCHPE at the end of the course, it is important for each participant to sign an attendance sheet and hand in an evaluation form at each session. The sign-in sheets and evaluation forms will be made available at the start of each session.

Session Format: Each weekly session has been roughly divided into two sections. We will start each session with a didactic lecture (45 minutes to 1 hour), followed by a brief coffee break.  After the break, sessions will resume using a more informal workshop format, with case discussions, role playing, film clips and other elements where more practical skills will be developed.

NB. Note that there will be time for participants to discuss their own cases in sessions 3, 5 and 6. If you are interested in taking advantage of this opportunity, please prepare a brief case description (5 minutes maximum) to present to the group for discussion.

Outline of Sessions

Session 1 -  What Clinicians Need to Know about Addiction  (October 28, 2011)

Part 1 - Didactic Session (Dr. Kathryn Gill, 1 hour)

Focus on conceptual models of addiction, pharmacology and phenomenology. Film excerpts the HBO Addiction series will be used at various points in the session. The session will address the following questions:

a) What is addiction? Focus on the signs and symptoms of addiction and how does it develops

b) Is addiction a brain disorder? Opinions from NIDA and the WHO

c) What are the effects of drugs/alcohol on the brain? A brief look at dopamine and GABA, drug-induced deficits in the brain circuitry controlling thinking and behaviour, and research using brain imaging techniques

c) Are some individuals more vulnerable to addiction?

Part 2 -   Workshop session (Dr. Kathryn Gill, Dr. Dara Charney) 

Case-based learning – group discussion of addiction (symptoms, behaviours, sequelae, diagnosis, comorbidities)

Session 2 - Screening and Assessment   (November 4, 2011)

Part 1 - Didactic Session (Dr. Kathryn Gill, 1 hour)

Methods for screening and assessment of drug/alcohol abuse in a variety of practice situations. Discussion of various screening tools including the WHO ASSIST and Deba-AD, as well as assessment instruments (Addiction Severity Index – lite and full versions). Film excerpts will be used to demonstrate motivational approaches to screening/assessing patients in several practice environments.   

Part 2 - Workshop (Dr. Kathryn Gill, Dr. Gail Gauthier) 

Group exercise – live interview designed to screen a patient for substance use/abuse using the ASSIST. Participants will conduct the screening, score the instrument and provide feedback to the patient, along with treatment recommendations. Discussion will centre on appropriate feedback based on level of dependence and psychosocial factors. 

Note – no session on November 11, 2011

Session 3 – Treatment Planning/Referral and Introduction to Brief Interventions (BI)    (November 18, 2011)

Part 1 – Didactic Session (Dr. Gail Gauthier, 1 hour)

Treatment planning – Using a decision tree, discussion will centre on who can be treated using a brief intervention, and who should be referred to specialized treatment. Introduction to the basic components of brief interventions, as well as inpatient and outpatient treatment options.

Facilitated referral - Information on the MUHC Addictions Unit program, self-help groups and other treatment centres in Quebec

Part 2 – Workshop (Dr. Gail Gauthier, Dr. Kathryn Gill)

Case-based learning – group discussion of participant’s cases in order to apply the decision-making algorithm. The session will also explore treatment options, and treatment planning.

NB. – please bring brief case summaries to present to the group for discussion. 

Session 4 -  Brief Interventions   (November 25, 2011)

Part 1 – Didactic Session (Dr. Gail Gauthier, 1 hour)

Structured Brief Intervention - description of a 5 session BI including key components, building motivation (education, feedback, cost/benefit analysis), goal setting, developing coping skills (identifying and handling triggers), drink/drug refusal skills including dealing with cravings and relapse prevention.  Demonstration of BI sessions and skill set will be provided throughout, based on videotapes of therapy sessions conducted with an actor.

Part 2 – Workshop (Helen Pentney, Dr. Gail Gauthier)

Role Play – practicing the elements of BI. Participants will practice in small groups with guidance from instructors.

Session 5 - Approach to Concurrent Disorders I   (December 2, 2011)

Part 1- Didactic Session (Dr. Dara Charney, 1hour)

This session will address issues related to comorbidity between substance dependence and other disorders including depression and anxiety. The didactic component will explore assessment, diagnosis and differential diagnosis, including information on how to tease out overlapping phenomenology (e.g. withdrawal agitation vs. anxiety). The effects of drugs/alcohol on psychiatric symptomatology, course and response to treatment will be discussed.

Part 2 – Workshop (Dr. Dara Charney)

Live Interview – patient with concurrent mood and substance use disorders.

Case-based learning - group discussion of participant’s cases.  NB. – please bring brief case summaries to present to the group for discussion.  

Session 6 - Approach to Concurrent Disorders II   (December 9, 2011)

Part 1- Didactic Session (Dr. Ron Fraser, 1 hour)

The didactic component of this session will explore assessment, diagnosis and differential diagnosis for comorbidity related to psychosis and personality disorders. The treatment of addicted patients with chronic pain syndromes will also be addressed. Information on how to tease out overlapping phenomenology (e.g. drug-induced anergia or apathy vs. anhedonia or blunted affect) will be presented. Course and response to treatment will be discussed, along with information on when to refer to specialized addictions treatment.

Part 2 – Workshop (Dr. Ron Fraser, Dr. Dara Charney)

Live Interview - patient with concurrent borderline personality and substance use disorders.

Case-based learning - group discussion of participant’s cases. NB. – please bring brief case summaries to present to the group for discussion. 

Faculty from the Addictions Unit, MUHC

The Addictions Unit: http://muhc.ca/addictions_unit/profile/addictions-unit The Griffith Edwards Centre is administered as part of the MUHC out-patient Psychiatry department and is officially designated as an English language facility--serving the greater Montreal region. It is a hospital-based addictions service that provides a continuum of care for adults with drug/alcohol and mental health disorders including medical detoxification conducted within the inpatient psychiatry unit at the Montreal General Hospital.

Dara Charney M.D., FRCP(C)

Dr. Charney is a staff Psychiatrist at the Addictions Unit, the Director of the McGill RUIS Addiction Program, the Associate Chair (Education), Department of Psychiatry, McGill University and an Associate Professor, Department of Psychiatry, McGill University. She was the Program Director for McGill Psychiatry Postgraduate Education from 2002 to 2010. Her clinical and research work is conducted at the Addictions Unit where she initiated a number of clinical trials and prospective treatment outcome studies with substance use disorder clients, with a particular emphasis on "dual disorder" clients. She has received research funding from the MUHC Research Institute, FRSQ and CIHR, as well as salary awards from both the MUHC Research Institute and FRSQ.

Ron Fraser M.D., FRCP(C)

Dr. Fraser is a staff Psychiatrist at the Addictions Unit and the Head of the MUHC Inpatient Detoxification Service, and an Assistant Professor, Department of Psychiatry, McGill University. He completed his residency training in psychiatry at McGill University, as well as a fellowship in Addictions Psychiatry, studying heroin dependence and detoxification techniques. After working in rural Nova Scotia, he returned to McGill University in order to head the Addictions Unit inpatient detoxification service. In addition, he runs a long term treatment program for clients with Borderline Personality Disorder at the McGill University Health Centre. He is currently the Residency Training Director at the MUHC for psychiatry.

Gail Gauthier Ph.D.

Dr. Gauthier is the Clinical Director of the Addictions Unit. She is a clinical psychologist and member of the Order of Psychologists of Quebec. She has a Master’s degree in Counselling Psychology from McGill University. Following her Master’s degree, she completed an internship in cognitive behavioural therapy at the Montreal General Hospital Behaviour Therapy Service, where she specialized in the treatment of anxiety and eating disorders.  She obtained her Ph.D. in Psychiatry at McGill University. Dr. Gauthier has conducted research examining outcomes of therapy for addiction, including factors associated with treatment retention, and treatment comparisons of brief intervention and standard therapy. Her current clinical work is individual and group therapy with clients with substance use and mental health disorders, and her therapeutic expertise is in cognitive behavioural, psychoeducational, and humanistic approaches.

Kathryn Gill Ph.D.

Dr. Gill is the Director of Research at the Addictions Unit and an Associate Professor in the Department of Psychiatry and member of the Division of Transcultural Psychiatry at McGill University. She obtained her Ph.D in psychology, and conducted post-doctoral studies at the Alcohol Research Centre, and the Addiction Research and Treatment Services of the University of Colorado. She divides her time between working at the Addictions Unit treating patients with drug- and alcohol dependence using a combination of group and individual CBT-oriented psychotherapy, teaching at McGill University and conducting research. The clinical research program includes projects related to gambling practices and addiction among the Cree peoples of James Bay, as well as clinical and biological predictors of treatment outcome. She has received research funding from the MUHC Research Institute, CQRS, FRSQ, SSHRC, FQRSC and CIHR, as well as salary awards from both the MUHC Research Institute and FRSQ.

Helen Pentney O.T., ICADC

Helen Pentney was a staff therapist at the Addictions Unit (retired June, 2011). She received a diploma in Occupational Therapy from the British Occupational Therapy Association and an International Certificate in Alcohol and Drug Abuse Counselling from The Canadian Federation of Addictions Counsellors. She has extensive experience assessing and treating patients with substance use disorders, and cognitive functioning. In addition she has had extensive experience teaching group psychotherapy skills to occupational therapy students, medical and psychiatric residents and psychology interns.

MUHC Addictions Unit Training Program

 Treating Substance Dependence and Mental Illness:

 Tools for Practitioners

           Allan Memorial Institute, 1033 Peel Street         

Registration Form

Schedule:  Friday afternoons, 1-4 p.m., from October 28 to December 9, 2010 (excluding November 11^th). All sessions will take place at the Allan Memorial Institute, 1033 Pine Avenue West, in the South Seminar Room P1.086

Contact Person: Ms. Lyne Marchand; ext.42066; lyne [dot] marchand [at] muhc [dot] mcgill [dot] ca

Fee:  $300 including applicable taxes. Cheques should be made payable to: The Addictions Unit Fund 

Send Registration Form and Cheque to: Ms. Lyne Marchand, MUHC Addictions Unit, Griffith Edwards Centre, 1547 Pine Ave., Montreal H3G 1B3

Last Name: ________________________________        First Name: ________________________________

 Profession:________________________________        Position: ___________________________________

 Department: ______________________________        Institution: _________________________________

 Address: _______________________________________________________________________________________

 Postal Code: ________________                        Phone:_____________________ Ext.___________

 Fax: ________________________                          E-mail:___________________________________

Accreditation: This event will be accredited by the Centre for Continuing Health Professional Education, Faculty of Medicine, McGill University for a total of 18 credits. All participants must sign the attendance sheet available on site in order to receive accreditation. A certificate of attendance will be distributed to all participants after the course

Cancellation:  Due to the limited number of spaces available, for written cancellations received on or before October 1, 2011 an amount of $50 will be retained. After October 15, NO REFUND will be issued

 GST# - 10750-8160-PG-0001

PST# - 1006116325-RS-0001