Putting Evidence Based Practices (EBP) Into Action

The entire curriculum, from beginning to end, is designed to help clinicians implement and put into practice EBP in the treatment setting.

First, integrated treatment is recognized as evidence-based practices and is a national priority – even a requirement.

Secondly, EBP states that co-occurring psychiatric and substance dependence disorders are brain disorders in biologically vulnerable individuals. A brain disorder focus then logically leads to a brain healing treatment.

Evidence Based Practices have been established in the areas of the System, Program Design and Guidelines, Clinical Practice Content, Approach, Relationship, and integrated treatment of the Person with co-occurring Psychiatric and Substance Disorders. EBP and the complete sources are in Evidence Based Practices (EBP) under the main menu heading FOUNDATIONS OF THE BASICS.

Putting EBP into a comprehensive curriculum was accomplished by:

1. Developing and designing a curriculum based on the principles of evidence-based model The Comprehensive Continuous Integrated System of Care or CCISC (Minkoff & Cline, 2004, 2005).
   1. Principle 1. Co-occurring issues and conditions are an expectation, not an exception.
   2. Principle 2. The foundation of a recovery partnership is an empathic, hopeful, integrated, strength-based relationship
   3. Principle 3. All people with co-occurring conditions are not the same, so different parts of the system have responsibility to provide co-occurring-capable services for different populations.
   4. Principle 4. When co-occurring issues and conditions are present, each issue or condition is considered to be primary.
   5. Principle 5. Recovery involves moving through stages of change and phases of recovery for each co-occurring condition or issue.
   6. Principle 6. Progress occurs through adequately supported, adequately rewarded skill-based learning for each co-occurring condition or issue.
   7. Principle 7. Recovery plans, interventions, and outcomes must be individualized. Consequently, there is no one correct dual-diagnosis program or intervention for everyone.
   8. Principle 8. CCISC is designed so that all policies, procedures, practices, programs, and clinicians become welcoming, recovery- or resiliency-oriented, and co-occurring-capable.
2. Aligning with the Stages of Change Model (Prochaska, Norcross & DiClemente, 1994).
3. Interweaving carefully and purposefully into the text and the handouts the specific principles set forth in EBP of counselor values, attitudes, and beliefs (Co-Occurring Psychiatric and Substance Disorders in Managed Care Systems: Standards of Care, Practice Guidelines, Workforce Competencies, and Training Curricula, 1998).
4. Including, from the beginning to the end, the most significant predictors for treatment success of empathy and hope (Minkoff, 1998).
5. Incorporating the most important counselor qualities of maintaining a consistent, nonjudgmental, and positive attitude (Montrose & Daley, 1995).
6. Matching in approach and “spirit” the principles of Motivational Interviewing (Miller & Rollnick, 2002).
7. Providing specific treatment topics and program content (1998 Report from the Panel of National Experts; Panel Chair Kenneth Minkoff, MD).
8. Detailing (using conversational language) the research-based neurochemistry studies –
   originally from the Decade of the Brain – identifying dual diagnosis as brain-based disorders in genetically vulnerable individuals. Additional studies continually validate these studies (National Institute of Mental Health & National Institute on Drug Abuse).
9. Incorporating over 1,600 references released in a 1,200 page two-volume set of THE BASICS, Second Edition. 

There are, of course, many very excellent publications on Dual Diagnosis and on Co-Occurring Disorders. Each has something to provide that is unique and helpful.

Yet, what is unique and helpful about THE BASICS, Second Edition: A Curriculum for Co-Occurring Psychiatric and Substance Disorders; 2020 Printing? The curriculum fills the gaps between the science and the person. 

1. THE BASICS eliminates the gap between the system and the professionals providing the services.
2. Between the science and the individual seeking services.
3. Between the Evidence Based Practices (EBP) and the person seeking services.
4. THE BASICS is a compendium of materials designed to help individuals with co-occurring disorders by providing professionals with materials designed to teach the EBP skills by providing a continuity of care.

Dual diagnosis experts in the references listed above clearly state that the goal for clinicians is to develop basic knowledge of psychiatric and substance disorders and their interactions, as well as the skills, to be able to consistently demonstrate familiarity with an integrated disease and recovery model.

The goal of providing quality and comprehensive psychoeducational curricula is also addressed in these reports – as well as from numerous other national and international professionals – combined with our own ethical standards of service delivery.

All chronic and acute medical disorders begin with stabilization of the affected organ of the body. It’s commonsense that the treatment of a broken leg typically starts with a cast and not a cane. And that approach is consistent from provider to provider. There is a difference between the organ of the body – the heart – that is functioning as it is intended and the heart that is not. Every organ of the body has the potential of experiencing functioning difficulties, deficiencies, or over production.

The organ of the body involved in stabilization of dual diagnosis is the brain. The brain is more challenging to describe and often more of a challenge for a person to recognize or even want to discuss. People often feel that something “wrong” with the brain means there is something wrong with “them” instead of realizing that the brain is just an organ of the body.

Understanding brain-based disorders means that all the psychoeducation and the treatment focus on activities and treatment is related to the brain. That includes understanding the functioning, the disorders, and the healing to that organ of the body – the brain. These topics then will, of course, highlight stress management, nutrition, emotional management, cognitive-behavioral therapy, and so many more related to brain health and symptom stability.

The design of each Lesson Plan located in the main heading LESSON PLANS in the main menu heading on the home page are based on the evidence based practices of: