Welcome to the Recovery to Practice virtual grand rounds, clinical decision support for
providers serving persons with serious mental illness.
On behalf of the substance abuse and mental health services administration we’d like
to welcome you.
This webinar series is hosted by SAMHSA’s Recovery to Practice initiative.
The overarching goal is to improve the knowledge and skill of the behavioral health workforce,
and transform concepts of recovery‐oriented practice into guidelines and clinical interventions.
This series features six short mini‐webinars built around a composite case a scenario to
illustrate how to provide recovery‐oriented services to people with co‐occurring mental
health and substance use conditions, and to develop a system that is recovery oriented.
This webinar series will illustrate how a series of six core principles of recovery‐oriented
treatment for individuals with co‐occurring mental health and substance use conditions.
Complexity is an expectation.
Service partnerships are emphatic, hopeful, integrated and strength‐based.
All people with complex issues are not the same.
For people with complexity, all co‐occurring conditions are primary.
Parallel process of hopeful progress for multiple conditions.
Adequately supported, adequately rewarded, skills‐based learning for each condition.
The material in this series is organized into two courses with three modules each or can
be viewed individually.
Supplemental resources are available for each webinar.
You can also access information on how to receive CMEs for your participation in these
courses.
The first course contains the following three webinars: becoming familiar with the principles
of recovery‐oriented care, conducting an integrated strengths‐based assessment, and
addressing psychopharmacology and other medication‐based decisions.
The second course contains these three topics: increasing participation and activation through
engagement and cultural competency, utilizing stage‐based interventions and peer support,
and maintaining recovery over time and challenges.
This webinar series is presented by a team of national experts in the field of recovery‐oriented
approaches to treatment and services for people with serious mental illness and co‐occurring
disorders.
You can find more biographical information about these presenters as it’s available
in the supplemental materials for this course.
Now it's time to meet Nick.
He is a fictitious individual with a story we can learn from.
You can download a copy of Nick’s story from the supplemental materials, as it may
be helpful to have on hand while you participate in the webinars.
Nick is a 32‐year‐old man, a father, a naturalized US citizen and a Christian.
He has been referred to you for treatment for depression and substance use.
Nick has many challenges but also many strengths.
We will use Nick’s story to help you understand how to approach individuals using services
from a recovery‐oriented standpoint.
Nick M. is Brazilian, who immigrated to the US when he was 18 years old to further his
education.
Nick has become a naturalized US citizen.
His parents and siblings continue to live in Rio de Janeiro, Brazil.
Nick was married at 22 and is recently divorced.
His wife states that during their marriage, he often came home drunk and was verbally
abusive to her.
He has two young children, a 10‐year‐old daughter and an eight‐year‐old son who
live with his ex‐wife 40 minutes away.
He currently lives in a single room in a residential hotel.
He says he loves his children and periodically takes the bus to visit them.
He has no other immediate or extended family that lives nearby.
Although Nick describes his primary support as the members of his church, he spends a
great deal of his time by himself and describes his life as a bit lonely.
He is Roman Catholic by faith and attends services regularly.
Nick is currently unemployed and on public assistance, but he wants to find work to provide
for his children.
Before he was on public assistance, he worked sporadically doing off‐the‐books jobs.
Nick started drinking when he was a young teenager living in Brazil.
Drinking was a common part of hanging out with friends.
Recently Nick was admitted to a detox unit from the emergency department in a general
hospital after a period of heavy drinking.
This was Nick's second admission to a detox unit.
His initial admission was three years ago.
However he did not follow through on his referral to an outpatient addiction treatment program.
With his last discharge from the detox unit he agreed to be hospitalized due to his severe
depression.
He was observed to be withdrawn, with little energy, and had trouble concentrating.
He had suicidal thoughts but no real plan to harm himself.
According to hospital records, he had become increasingly depressed following a relapse.
Nick denies ever using drugs and began drinking alcohol heavily six years ago.
Since then he has had several alcohol‐related problems, including an arrest for disorderly
conduct.
He experienced depressive episodes within one year after immigrating to the US, shortly
after his daughter was born, and with this recent admission.
He has been prescribed antidepressants in the past, but stopped them because he did
not like the side effects.
He also stopped attending his outpatient appointments because he was looking for work.
Nick has been diagnosed with severe alcohol use disorder, relapse, and major depression.
Upon his discharge from the hospital he was referred to your mental health clinic for
treatment.
He is not currently receiving any mental health services or substance abuse treatment.
Early in your first visit with Nick he states, “Well, here I am.
Where do we go from here?
I mean, I'm not going to feel like this for the rest of my life, am I?”
Nick has a great deal going on in his life—mental health concerns and substance abuse problems
that are seriously impacting his life, work, and his relationships and his willingness
to engage in treatment and services.
How can a clinician or prescriber draw from recovery‐oriented principles and practices
to best help Nick?
The six modules of this RTP virtual grand rounds will help us learn from Nick and his
situation.
So what do we mean by recovery or recovery oriented?
In 2011 SAMHSA released a working definition of recovery and a set of guiding principles
that incorporate aspects of recovery from both substance use and mental health.
These 10 components of recovery, along with these four major dimensions that
support a life in recovery, help to form a structure and foundation for developing recovery‐oriented
lives, and building recovery‐oriented services and systems.
To learn more about recovery to practice, you can subscribe to our quarterly newsletter
by emailing us at RTPnet.com, or by visiting the SAMHSA RTP website