What’s Working in Treatment and Prevention, May 2005
A Co-Occurring Curriculum
That’s Worth Its Weight
THE BASICS, Second Edition: A Curriculum for Co-Occurring
Psychiatric and Substance Disorders
By Rhonda McKillip
By Lindsay E. Freese, M.Ed., MAC, LADC
My first response to The Basics was to the mere size of it. It is clear why there are two volumes, and if the adage is true that “more is better,” then this 1,200-page curriculum for service providers working with the dually diagnosed has to be fantastic. And after figuring out how one would use The Basics, Second Edition, I would tend to agree.
With all this information at my fingertips it took me a while to settle down enough to understand how to put it all to good use. When I first picked up the curriculum and started browsing the pages, I found that I couldn’t stop. There is some great stuff in here, and I spent a considerable amount of time reviewing information but not gaining the rudiments of what, in a treatment setting, I might be doing with all of it. It was quite overwhelming! To my great relief, once I disciplined myself and started from the beginning it was clear that McKillip had engineered an approach that is well laid out.
She clearly explains how to present the voluminous amount of data in a “Master Procedural Guide for Professionals,” outlining several different approaches for doing so depending on the treatment setting and the time available. The clinician has to be aware, however, that he or she will need to put in a considerable amount of time in preparation to use this curriculum. There is a clear focus on clinician aptitude given the subject matter, and an emphasis on the need for cross-training between the disciplines of mental health and addiction.
The curriculum includes “Tips to Professionals” placed throughout the text regarding recommendations for exactly how to present the materials, augmenting the data with the use of included handouts, and various appendices containing additional topic information as well as hints. These hints pertain to presentation style, such as using visuals, allowing adequate time for the review of handouts, and making generous use of empathy and hope.
There is also a “Master Tips to Professionals” section at the end of Volume One, which contains 39 tips. Any treatment professional, regardless of whether he or she is using this particular curriculum in actual treatment, would benefit from the data included within these 39 tips.
The curriculum itself is divided into eight subjects. McKillip at her website (http://mckillipbasics.com) outlines the subjects as follows:
- The Link Between Psychiatric and Substance Disorders, An Integrated Treatment Approach
- Psychiatric Disorders Within a Co-Occurring Diagnosis
- Substance Disorders Within a Co-Occurring Diagnosis
- The Physiological Effects of Psychiatric and Substance Disorders on Physical Health
- Coping With Stress and Emotions With Healthy Alternatives to Alcohol and Other Drug Abuse
- The Foundations of the Recovery Process
- The Process of Recovery
- Coping With Crisis, Preventing Relapse, and Maintaining Recovery
In addition to the subjects there are four drug categories appendices: 1. Effects of Alcohol and Other Drugs on Mental Health; 2. Acute Withdrawal Symptoms of Alcohol and Other Drugs; 3. Effects of Alcohol and Other Drugs on Fertility, Pregnancy, Delivery, and Prenatal Effects on Infants Through Their Adulthood. There are also two cross-training appendices: 1. The Basics and Symptoms of Psychiatric Disorders; and 2.The Basics About Substance Disorders.
Each of the eight subjects has multiple subtopics too numerous to mention here in their entirety (check the website), but as an example within the first subject they are: Mental Health and Substance Use Disorders Defined; Categories of Co-Occurring Disorders; History, Philosophies and Barriers to Treatment; The Integrated System of Care; The Brain-Body Connection; Bio-Psych-Social Concept of Dual Disorders; Personal Identity, Culture, Diversity, Change, Motivation, Choices; and Harm Reduction and Abstinence.
Each subject starts with a Presentation Guide, which is organized into three segments (Prepare, Present and Practice) and then further broken down into areas pertaining to the professional and the group, subject materials and appendices, handouts and group closure. Data presentation is based on sound clinical approaches such as “stages of readiness for change” theory. In addition, the author leads you through appropriately maintaining measurable goals and objectives. Participants’ strengths, cultural diversity, diagnosis, functioning level, and severity and acuity of specific disorders are considered.
In addition to the usefulness of this curriculum for treatment audiences, I also see value in the area of education. Using this as a classroom text in either addiction or mental health counselor training programs would enable the student to gain not only a significant amount of data on dual diagnosis issues but also a clear sense of how this information is presented in the context of treatment. As always, the teacher learns more than the student, and anyone using this curriculum will learn a great deal even if it is used only as a reference.
For those interested in a closer look, THE BASICS sells for $100 plus shipping and can be ordered directly from McKillip’s website. I don’t think any serious student of mental health and addiction will be disappointed with what is offered.
Lindsay E. Freese is a professor of human service at New Hampshire Technical Institute and a member of the Additional Professional editorial advisory board.