How to Tell if Someone Needs Treatment

Tuesday, June 30th, 2015

Dr. Mee-Lee, MD Trains Staff on ASAM CriteriaA recent staff training by world-renowned expert, David Mee-Lee, M.D., focused on the criteria that clinicians use to tell if someone needs treatment, and suggests Phoenix House’s commitment to clinical excellence. Entitled “Understanding, Using, and Implementing the ASAM Criteria in a Managed Care Environment” and held on June 16, 2015 at Phoenix House Academy in Lake View Terrace, California, the workshop prepared well over 120 clinicians from Phoenix House and Tarzana Treatment Centers in California for the shifting requirements of health care system. Those requirements will include the use of ASAM Patient Placement Criteria in all substance abuse treatment programs.

Addressing the upcoming change, the workshop covered “what is new and how to implement ASAM Criteria principles of continuum of care, levels of care, clinically driven, individualized treatment and recovery-oriented systems of care,” with a focus on how to carefully assess clients, design outcome-driven service plans, and effectively manage care.

The counselors and mental health professionals of Phoenix House will be implementing in their daily practice what they learned from Dr. Mee-Lee: how to organize a multitude of data to individualize client treatment and placement and how to use the ASAM for this purpose. The ASAM Criteria evaluate the severity of impairment and level of functioning of the prospective patient, taking into account the following issues:

  1. acute intoxication and/or withdrawal potential that requires admission to an emergency room or hospitalization;
  2. biomedical conditions and complications, such as diabetes, heart disease, etc., that require ongoing medication and treatment;
  3. emotional and behavioral conditions and complications that impact substance abuse;
  4. readiness to change (or being unwilling to change, but only mandated for treatment);
  5. continued use of drugs or alcohol; its potential for causing problems and negative consequences;
  6. positive recovery environment (support of having stable housing, sober and clean friends, solid and supportive family relationships, being employed, etc.).

During the workshop, Dr. Mee-Lee spent a long time on individual case studies, which all staff evaluated with possible assessment levels. Their rationales for making certain assessment choices were discussed and compared (ranging from 0 to 5 in some cases), showing how subjective these assessments may be and how hard it is to decide what aspects of a person’s experience or history are the most relevant when selecting the most appropriate level of treatment. Counselors, supervisors, and the director engaged in thoughtful discussion, comparing notes, and making arguments for their choices.

Dr. Mee-Lee with Scott VanCamp at Phoenix HouseIt is only through decades of such clinical practice that a mental health professional is able to use such assessment criteria to the full benefit of a client. As a helpful tool, Dr. Mee-Lee suggested the use of three “H”s : 1) History, 2) Here and now, 3) How worried should you be right now. For instance someone with a history of overdosing, who has not used drugs for many years and is not in immediate danger has less risk than someone who is currently using drugs and is unstable on many other domains, such as homeless, in conflict with their family, and unemployed.

David Mee-Lee, M.D. is a board-certified psychiatrist, and is also certified by the American Board of Addiction Medicine. Based in Davis, California, he trains and consults both nationally and internationally. Dr. Mee-Lee is Chief Editor of the American Society of Addiction Medicine’s (ASAM) Criteria for the Treatment of Addictive, Substance-Related, and Co-Occurring Conditions and is Senior Vice President of The Change Companies. He is also a Senior Fellow, Justice Programs Office (JPO) of the School of Public Affairs (SPA) at American University, Washington, D.C. Dr. Mee-Lee has over 30 years of experience in person-centered treatment and program development for people with co-occurring mental health and substance use conditions. No wonder, that, with these credentials, he was such an effective teacher.

The workshop, envisioned by Elizabeth Stanley-Salazar, VP and Clinical Director at Phoenix House, with Albert Senella, CEO at Tarzana Treatment Centers, was organized by the National Clinical Training Department of Phoenix House Foundation. “The ASAM criteria and the body of supportive resources available through the American Society of Addiction Medicine are invaluable tools related to person-centered treatment provision,  the event’s coordinator, Scott VanCamp, LMFT, Senior Director of Special Projects at Phoenix House, noted. “The further integration of these tools into our regional practices has the potential for great clinical enrichment through the whole recovery process, from assessment to program completion.”

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If you or your loved one – your son or daughter – need substance abuse treatment services, or help dealing with mental health issues by consulting with well-trained, experienced, dedicated and compassionate professionals, please do not hesitate to call us at: 1 888 671 9392.

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