Day 3 :
- Symposium 3 : Addiction Treatment Alternative
Location: Main Hall Northbrook Hilton Chicago
Mahidol University, Thailand
Prapapun Chucharoen has completed Ph.D. in Neuroscience at the age of 38 years from Mahidol University. She is the director of Master of Arts program in Addiction Studies, ASEAN Institute for Health Development, Mahidol University, Thailand. This is the only Master Program in addiction studies in Southeast Asia. This program aimed to create social leader/ practitioner in the field of addiction studies. Those who graduate from the program will be capable of practicing as well as conducting research in this discipline in order to support the social environment of a country with respect to the prevention and alleviation of narcotics and others addiction problems. The therapy and rehabilitation of addicts is also included in the curriculum. She has published more than 25 papers in journals and serving as an editorial board member of Journal of Public Health and Development Thailand.
Drug and Alcohol dependence are health problem. Although some treatment program can be helpful for those problems, but there is no single treatment for everyone. Recently show an alternative medicine is one of choice. There are interesting interventions which success in rehabilitation. For example acupuncture, massage therapy, Yoga and meditation. This symposium focus evidence based of addiction treatment alternative or alternative medicine in drug and alcohol rehabilitation program.
Drug & Alcohol Rehab Asia (DARA), Thailand
Title: Culturally sensitive realignment, re-entry and recovery utilizing cognitive behavioral therapy with formerly incarcerated clients
Time : 09:00-09:25
Roland is an interventionist, author, trainer, counselor and consultant specializing in addiction-related issues. Roland is currently the Director of Clinical Operations for DARA Thailand, and the Clinical Director for Lionrock Recovery. He is also the President and Founder of Free Life Enterprises counseling and consulting firm. He is the co-founder and former Executive Director of Alta Mira Recovery Programs, in Sausalito, California, as well as co-founder and former Clinical Director of Bayside Marin, in San Rafael, where he designed the initial clinical model for each facility. He worked at Good Samaritan Hospital in San Jose, CA. for 15 years, he was the Director of Behavioral Health Services, where he was responsible for the psychiatric and chemical dependency programs. He was one of the first Licensed Advanced Addiction Counselors in the State of California, a member of Department of Alcohol and Drug programs advisory board, he sat on the oral examination board of CAADAC, (California Association of Alcohol and Drug Counselors), and is a member of the NAADAC Trainers Academy, providing technical assistance and training nationwide. He has provided counseling and consulting services to individuals and treatment facilities worldwide, including Switzerland, Holland, France, Dominican Republic, Italy, Thailand and the United Kingdom. Roland works with the Offender Mentorship Certification Program teaching CAADAC classes to incarcerated inmates. He has published 3 books related to Relapse Prevention from a cultural perspective and written numerous articles on addiction and recovery.
This engaging and challenging presentation allows participants to examine the implications both positive and negative of cultural considerations in the recovery and treatment of addiction with fomerly incarcerated clients. The impact of Cognitive Behavioral Threrapy on achieving positive treatment will be examined outcomes and discuss practical applications on CBT in the clinical setting. How the Recovery movement itself is a culture, complete with rituals, language, bias and prejudices will also be examined. The specific challenges of members of various cultures experience as they participate in treatment and self help support groups will be explored. Also symptoms experienced by formerly incarcerated clients, particularly Post Incarceration Syndome and Institutionalized Personality Syndrome will be examined. Participants will have an opportunity to identify their own prejudices and bias, and determine how they affect treatment outcomes in the form of counter-transference. Participants will learn specific cross-cultural counseling techniques that will increase their effectiveness and client retention rates. By exploring methods of assisting clients and treatment providers to realign themselves and their practicies in turn, it will be discussed how to move past the victimization of oppression and into the Healing of Recovery. Objectives: 1. Participants will have increased understanding regarding cultural issues and their impact on treatment outcomes. 2. Participants will learn specific cross-cultural counseling techniques that can be applied immediately in their workplace. 3. Participants will have an improved understanding Cognitive Behavioral Therapy techniques and learn practical methods of utilizing these techniques in their clinical practice. 4. Participants will develop strategies for introducing and facilitating cultural themed support groups with formerly incarcerated substance abusing clients. 5. Participants will learn techniques to help themselves and their clients overcome barriers to treatment and recovery and realign themselves and their practices in a direction that achieves more positive treatment outcomes.
Drug & Alcohol Rehab Asia (DARA), Thailand
Time : 09:25-09:50
Martin Peters is the Director, Drug and Alcohol Rehab Asia (DARAA). He has worked in a variety of settings within the healthcare sector over the past 20 years. After receiving BA (Hons) in Social Policy and Administration from the University of Plymouth (UK), his studies and passion for working with people led on to a Diploma of Higher Education in Nursing Studies with Registered Nurse status from the University of the West of England (UK). He continued to undertake continued professional development, obtaining numerous Nurse & Midwifery Council accredited certifications in Mental Health and Healthcare Management. He is currently undertaking a Certificate in Cognitive Behavioral Therapy (CBT) with the University of the West of Scotland (UK) leading to a Diploma in CBT. Throughout his career, he worked with people who have required support and guidance in a number of difficult and challenging situations, assists people in empowering themselves to live a life free from the grip of addiction and illness, working with complementary, modern, and traditional approaches incorporating best clinical practice.
Cognitive-Behavioral Therapy (CBT) was developed as a method to prevent relapse when treating alcoholism, and later it was modified for individuals with substance use disorder. Cognitive-behavioral strategies are based on the theory that in the development of maladaptive behavioral patterns like substance abuse, learning processes plays a significant role. The use of CBT is to learn to identify and correct addictive behaviors by using a range of different skills that can be used to prevent drug abuse and to address anassortment of other problems that often co-occur with it. A central element of CBT is anticipating likely problems and enhancing clients’ restraint by helping them expand effective coping strategies. Specific techniques include looking into the positive and negative consequences of drug use, self-monitoring to identify cravings on the onset and recognize situations that might put one at risk for use, as well as developing strategies for coping with cravings and avoiding those high-risk situations. Research indicates that the skilled individuals become skilled through cognitive-behavioral approaches which remain after the completion of treatment. Current research focuses on how to produce even more influential effects by combining CBT with medications for drug abuse and with other types of behavioral therapies.
Mahidol University, Thailand
Lacha Rueangkit completed BPolSc in 2013. She is a Master student of Addiction Studies Program, ASEAN Institute for Health Development, Mahidol University. Her research is in the area of alternative treatment in addiction with an interest in research on drug and alcohol addiction.
Drug addict treatment program aims in recovery of mind and body in the clients. Holistic approach is explored and represented for mind and body together. In addition, those programs will set up intervention support cognition and behavioral change. Recently, addiction treatment alternatives were used. This study was action research and aimed to study effective 12 steps in methamphetamine addict. According to 12 steps recovery program, the Buddhist principles were applied which focuses on faith and wisdom. It always reviews your own past actions and they should accept the mistakes of the past. Besides that, they should be guilty to the person in respect and apology should be made. Whenever clients have adopted 12 steps according to Buddhist principles, they not only can modify their methamphetamine abstinence but can also achieve happiness in daily life. The result showed the clients changed during continuum care and prevent relapse. Finally they achieved the quality to live a happy life.
Coffee Break 10:30-10:50 @ Foyer
- Workshop Session
Bringing it all together: Valuing the expertise of lived experience of recovery from a multicultural perspective
Location: Main Hall Northbrook Hilton Chicago
G. Chip Kosboth
Existential Psychotherapist, USA
Founder and Executive Director
PARfessionals: Peer Advocates for Recovery, USA
Title: Bringing it all together: Valuing the expertise of lived experience of recovery from a multicultural perspective
Time : 10:50-11:50
Jorea Kelley-Hardison is the founder and Executive Director of PARfessionals: Peer Advocates for Recovery and is in dual recovery from mental illness and addiction. Jorea earned a B.S degree in Management and completed a M.A. degree in Criminal Justice from the American (Military) Public University System. She has obtained certificates in mental health, nonprofit management, applied forensic psychology services, family and business mediation, substance abuse, as well as emergency management. In addition, she has received training throughout the years in the subject areas of rape/domestic violence crisis intervention, hospice, and health unit coordination from various professional organizations and colleges. Jorea holds the following credentials/designations: Certified Criminal Justice Addiction Professional-Applicant (CCJP-A), Peer Recovery Support Specialist (PRS), Peer Mentor/Peer Recovery Coach (PM-PRC), Nationally Certified Psychiatric Technician (NCPT), Certified Victims Advocate (CVA) and the Associate Prevention Specialist (APS).
Peer supporters bring the expertise of having lived and navigated the recovery experience, informing and enhancing clinical
client-centered practices. Peer supporters are often viewed by clients as being more culturally competent as a result of life
experience and can be more effective from a multicultural perspective. This workshop will incorporate the experience of a
credentialed young, minority peer with lived recovery experience.
Discussions will center on the Four Change Practice Principles:
1. Changing practice at an individual level
2. Focusing on change through recovery oriented training and including peer recovery training for staff and clients
3. Incorporating organizational changes to respond on an individual level
4. Collaborating to focus on valuing the changing workforce roles of peer supporters in behavioral health settings
In addition, speakers will take an in depth examination of The Practice Guidelines for Resilience and Recovery Oriented Treatment as described by the Philadelphia Department of Behavioral Health and Intellectual disability Services.
- Clinical Science Oral Speakers
Location: Main Hall Northbrook Hilton Chicago
William S. Jacobs
University of Florida, USA
Barry Tolchard has been a clinician and gambling researchers for the past 20 years. He has published work on the outcomes of Cognitive-behavior Therapy for problem gamblers and examined the concomitant health factors associated with gambling. He was one among the team to create a new gambling screening tool (The Victorian gambling Screen) based on public health principles of harm. He is also the co-author of the New England 4G Framework for Guided Self-Health. This framework offers clinicians a model for working with people experiencing a range of mental and physical problems to find solutions to help themselves. He is currently the Deputy Head of School (Health) for research at the University of New England in Australia.
Gambling is on the rise throughout the world. Gambling operators are seeing new opportunities to introduce their products into less developed areas. Ghana has recently legalized gambling, giving residents the chance to play both online and with land based providers. There has been limited research into the impacts of legalizing gambling in Ghana, with no social impact or attitudinal data available. This paper will describe the first study to examine the attitudes to gambling of Ghanaian adolescents and the impact this may be having on their school attainment and mental well-being. A series of gambling attitudinal questions were asked of 693 adolescent alongside perceived social support and stress factors in relation to their educational attainment. The results indicate there is a strong view that Ghanaian adolescents consider gambling to be a positive experience and a possible way out of poverty. However, adolescents with strong positive attitudes to gambling experienced poor social support and high levels of stress, impacting on their overall education. The study concludes better gambling education is need in Ghanaian schools.
Alternatives Addiction Treatment, USA
Adi Jaffe completed his Ph.D at from The University of California in Los Angeles and postdoctoral studies from UCLA’s Semel Institute for Neuroscience and Human Behavior. He is the co-founder and executive director of research for Alternatives Addiction Treatment, a premier outpatient SUD treatment provider in Beverly Hills, California. He also founded and developed the first algorithm-driven SUD treatment-search tool that was used in the described study. He has published more than a dozen papers in reputed journals and serves on the editorial boards of a number of SUD journals.
Aims: To assess the feasibility and utility of mobile momentary-assessment breathalyzers within the context of an intensive outpatient (IOP) treatment for Alcohol Use Disorder (AUD).
Methods: Twenty-two participants in an IOP treatment program in Southern California were provided breathalyzers at the onset of treatment. Breathalyzer assessment schedules were set based on client’s self-report of sleep schedule and three to five assessment per day were conducted remotely. Breathalyzer data was recorded for the duration of treatment, which lasted between two-to-six months (M=2.3 months). Participants were given a short survey to assess their satisfaction with the Breathalyzer system. Data preparation and analysis was conducted using SAS 9.1.
Results: Analysis indicated substantial presence of missing data when looking at individual data points. Data was therefore aggregated by day, alleviating a substantial proportion of the missing data. Clients reported mostly positive feedback regarding their satisfaction with the Breathalyzer system and client performance in treatment was seen to correlate with their adherence to Breathalyzer reporting.
Conclusions: Our study reveals that the utilization of momentary substance detection methods, such as a Breathalyzer, within an IOP treatment context is feasible. Furthermore, the study reveals specific analysis recommendations for providers engaged in such data collection. Finally the use of reporting adherence as a measure of treatment progress is suggested given the relationship between treatment success and Breathalyzer reporting observance.
Addiction Specialist, USA
Time : 12:20-12:40
Sandra Rasmussen (PhD, RN, LMHC, CAS-F) is a certified Addiction Specialist in alcohol, other drugs, and gambling. She was recognized by the Virginia Public Health Association and honored by the University of Minnesota for her teaching excellence, practice expertise, management competence, research production, scholarly publications, and service contributions in addictions. She currently divides her time among clinical practice, graduate teaching, research, and writing. Her book Addiction Treatment Theory and Practice won the AJN Distinguished Book of the Year Award. A companion volume Addiction Recovery Theory and Practice is under contract. Recovery is her personal and professional passion.
The American Society of Addiction Medicine defines addiction as a primary, chronic disease of brain reward, motivation, memory and related circuitry. Genetics, together with bio-psycho-social-spiritual factors, account for the likelihood one will develop addiction or other RDS disorders. Health professionals can help individuals manage addiction and other RDs disorders to realize recovery: A different, better way of life with purpose and meaning. This presentation describes A Recovery Model for Addiction and other Reward Deficiency Syndrome Disorders. The quality of care concept developed by Avedis Donabedian suggests structure, process, and outcome as a way to organize the model. An ecological paradigm, empowerment theory, and evidence-based practice support this organization. Ten constructs frame the model: self and surroundings; management and self-efficacy; change, lifestyle, and well-being; risks for relapse, relapse prevention, and relapse. The model reflects the shift from the traditional medical psychiatric model of care toward the concept recovery. The definition of recovery advanced by the Substance Abuse and Mental Health Services Administration grounds the model. The model embraces the vision and overarching goals of Healthy People 2020. It reflects current addiction practice: i.e., the DSM-5 and the ASAM-3.Live well! Recovery is an idea whose time has come.
Central Michigan University, USA
Title: Psychiatric medical home model; Medical, substance use disorders and mental health cost savings
Time : 13:00-13:20
Ronald Howard Bradley, DO, PhD, FACN, works at Central Michigan University College of Medicine in Saginaw, Michigan. Board certified in pain medicine, addiction management, and forensic psychiatry, Dr. Bradley handles many types of psychiatric cases. He is Chief of Psychiatry for the University, and author of over 60 articles and book chapter contributor. In 1986, the American Osteopathic College of Neurology and Psychiatry awarded Dr. Bradley with a Sidney Kanef Memorial Award.
People with severe mental illness (SMI) die from the same chronic medical conditions as those in the general population (e.g., heart disease, diabetes, stroke, and pulmonary disease). However, these diseases are more common in people with SMI leading to death 25 years earlier than the general population. The modifiable health risk factors that contribute to these diseases—smoking, obesity, hypertension, metabolic disorder, substance use, low physical activity, poor fitness and diet—are also more common and have an earlier onset in people with SMI. Side effects of psychiatric medications, which may include weight gain and metabolic disorders, add to these health risks. The risk to African Americans with SMI is even greater due to existing racial health disparities. For example, African American men are 30% more likely to die from heart disease than non-Hispanic white males, 14% of all African Americans have diabetes, and 39% of African American males suffer from hypertension.This project will test the effectiveness of services interventions that specifically target young (18-40) AfricanAmericanmales with SMI. The objective of these service interventions is to reduce the prevalence and magnitude of common modifiable health risk factors that contribute to premature mortality in this population by reducing or eliminating racial and gender disparities in response to treatment for SMI and chronic medical conditions.The primary service intervention vehicle will be a patient-centered medical home model that integrates psychiatric and primary care. This project will embed primary providers (PCPs) in threedifferentCommunityMental Health centers,oneinalargemetropolitanarea,oneina midsizecity, and onefromarural community. The synergy that will result from this approach will address a key barrier to successfully managing these modifiable health risk factors: the reluctance of PCPs to treat an SMI patient’s chronic medical conditions for fear of being overwhelmed by the complexity of the patient’s mental health issues. The use of these three centers will provide data to facilitate the evaluation of the potential of this psychiatric-medical home model to be easily expanded to many settings, so as to reach a large portion of people with SMI.This psychiatric-medical home model has the potential to produce clinically significant health improvement and reduction in common modifiable health risk factors associated with early mortality in young African American males with SMI. The multidimensional treatment team, which includes psychiatrists, social workers, PCPs and nutritionists, is designed to target the multiple health risk factors that affect this patient population. A key service provided by this treatment team will be antipsychotic medication management that maximizes optimal psychiatric and functional outcomes while minimizing side effects and adverse health consequences. The service interventions provided through this treatment team will include diabetes prevention/management, cardiovascular disease prevention/management, fitness and diet improvement, psychotropic polypharmacy reduction and tobacco cessation.The project will include assessment of the following clinically significant patient-level outcomes that represent objective indicators of health improvement: improved glycemic levels, improved lipid levels, lowered cholesterol levels, healthier body mass index, lowered blood pressure, and reduced medical and psychiatric hospital admissions.
Akshaya Kambhatla, MD completed her graduated from Andhra Medical College in 2011. She was honored with Gold Medal for outstanding performance in Pathology during 2008 from N.T.R. University of Health Sciences, India. She served as Secretary of National Service Scheme (NSS), a volunteer of organization wing in her medical school from 2008-2010. She completed her USMLE exams and she is doing her rotations in various hospital setups to get US Clinical experience.
Metallothianeins (MT) and their four isoforms play a predominant role in coping up with the oxidative damage in the neurons and glial cells in the retina, pineal gland and especially in the hippocampus. MTs help sequestering zinc in the synaptic vesicles and maintaining redox potentials. It is documented that there is a varying concentration in zinc levels in several CNS disorders including chronic alcoholism. Along with genes regulating MTs , there are 639 genes affected due to chronic alcohol consumption like glucocorticoid receptor and the related gene FK506 Binding protein 5 (FKBP5), UDP Glycosyltranferase 8 (UGT8), urea transporter (SLC1A1) and interleukin 1 receptor type 1 (IL1R1). NF- kB signaling pathway leads to deleterious effects on hippocampus as the alcohol affects the genes modulating the cortisol pathway regulation and inflammation. There is also a study showing changes in the genes related to hypothalamic neurons made up of proopiomelanocortin (POMC) derived peptides leading to stress, metabolic and immune dysfunctions in people with family history of chronic alcoholism. In POMC neurons, the histone modifying proteins and DNA methyl transferase levels are altered and CPG di-nucleotides are increased in the proximal part of POMC promoter region. The epigenetic modification in POMC gene transmits through generation via male germ line as it was found that hyper methylation of the POMC gene was detected in sperm of the exposed offspring. A significant rise in c-fos gene is observed in offspring of chronically alcohol treated rats which may be the reason for the development of alcoholic motivation in the off springs of chronically alcohol treated animals.
University of Punjab, Pakistan
Naumana Amjad, Associate Professor at Institute of Applied Psychology, University of Punjab has been teaching for last 22 years, supervising undergraduate, MPhil and PhD level research. She obtained PhD from University of Warwick, UK in Psychology through the prestigious Annemarie Schimmel Scholarship. Her PhD research focused on understanding, prevention and control of individual and group aggressive behaviour and attitudes. She is President of Pakistan Psychological Association, Lahore Chapter. She started a self-help/ support group for families of addicts and actively supports Narcotics Anonymous Pakistan, a group of recovering addicts towards creating awareness about recovery. Recently completed research projects include: Emotional strengths and adversarial growth among families of addicts, Personal and interpersonal factors of first time drug use, relapse proneness scale. She has 2 books in process titled “Inside the Rehabs of Lahore” and a Monograph, “Addiction Research in Pakistan”.
The present study explored the relationship between beliefs about addiction of treatment providers, beliefs about addiction of persons with substance use disorders (PSUD’s), locus of control of PSUD’s and relapse proneness of PSUD’s. The sample was comprised of 120 PSUD’s and 17 treatment providers contingent upon availability. Self made demographic information sheet, Addiction Belief Scale (ABS) and Addiction Belief inventory (ABI), Drug Related Locus of Control Scale (DRLOC) and Advance Warning of Relapse Questionnaire (AWARE) was used to measure the desired variables. A series of partial correlations and hierarchical regression analyses revealed association between beliefs about addiction of treatment providers on disease model and beliefs about addiction of PSUD’s on inability to control aspect of disease model when controlling for education of treatment providers and education of PSUD’s. Moreover the relationship between beliefs about addiction of treatment providers and relapse proneness of PSUD’s was mediated by inability to control, responsibility for action, responsibility for recovery and genetic basis aspect of the beliefs about addiction of PSUD’s and the relationship between beliefs about addiction of PSUD’s and relapse proneness of PSUD’s was moderated by drug related locus of control of PSUD’s. The present study can help to set an obstinate ground for the planning of relevant relapse prevention strategies.
Singapore Prison Service, Singapore
Time : 15:00-15:20
Jasmin Kaur is a senior psychologist with Singapore Prison Service, Singapore. She conducts research on offending patterns, forensic risk assessment tools, and understanding offending behaviour. Prior to her research portfolio, she was a practicing clinician who provided group interventions for violent offenders. She completed her Bachelor of Social Sciences (Honours) from National University of Singapore and holds a Doctorate in Clinical Psychology from James Cook University, Australia. She is also currently an Adjunct Assistant Professor at the National University of Singapore.
What causes an abuser to relapse to drug use, especially when the consequences can result in incarceration? Positive and negative expectancies have been used to explain the motivation for drug use. Positive expectancies generate anticipation of the pleasurable effects of drug-taking, which increases the behaviour of drug-taking, whereas negative expectancies reflect motivations to reduce drug use. Depending on the individual, the variation of the strength of their expectancies would account for the individual differences of drug use patterns across contexts. These expectancies develop steadily and weigh more positively as drug use is maintained. The effect of a drug abuser is also a key in understanding drug use behaviour. Drug craving can be triggered by negative emotional states, events, cues of withdrawal episodes and information that the drug is not available. When the negative affect system is activated, this induces physiological reactions that are likened to withdrawal, and in turn also increases the desire to alleviate and relief negative affect through substance use. On the other hand, positive emotional states can activate the system, which induces increased effectiveness of drug-related cues, thoughts and actions. Therefore, drug craving and avoidance of withdrawal may act simultaneously in individuals. Drug users may take drugs for either the positive reinforcing effects or to avoid negative affect or for both reasons. Detailed interviews with drug users were conducted in order to determine the specific drug cognitions that initiated and maintained drug use in Singapore despite the strict legal restrictions on drug behaviour. The specific motives behind the processes of drug addiction are complex and vast, with several different perspectives to be considered. This includes individual (e.g. cognitive) and social factors. This qualitative study therefore aimed to understand the cognitions and motivations across the process of drug consumption (initiation of drug use, maintenance of drug use and the progress to addiction) for Asian drug offenders. Understanding the cognitions and motivations of drug offenders in Singapore is essential for future development of effective treatment programs, interventions and prevention strategies. This perspective will inform clinicians on the areas of focus for intervention and follow-through.
Poster Presentations Award and Closing Ceremony 15:30-15:40
Coffee Break 15:40-16:00 @ Foyer