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Harm Reduction and Mental Health: Working with Complex Drug Users

No matter what our education or work role is, we need to be able to offer services to people who present with difficult behaviors due to mental health problems or drug use. Harm reduction-informed services welcome people into a therapeutic relationship with a social service or health care worker. The goals of this training are to develop the skills to facilitate a change process with clients and to ensure safety and health during the process by offering practical harm reduction strategies.

This 4-day intensive course will introduce participants to the basics of mental health and illness and how they interact with drug use. We will then focus on the core principles,knowledge base and skills of harm reduction counseling that have been developed over the past 20 years. This intensive serves as the basis for understanding the complex interactions of mental health and drug use and how to work with them. It will be useful for therapists, counselors, case managers, medical professionals, outreach workers and others who need to engage complex clients.  Each day builds on knowledge and skills from the previous day. The first 2 days will provide participants with detailed information about mental health, mental illness, trauma, dual diagnosis, and the internal and external pressures that our clients cope with on a daily basis. The last 2 days will offer practical skills to engage, retain, and provide meaningful help to these clients. Topics covered include the neurobiology of drugs and emotions; the effects of trauma on substance use; mental health symptoms, managing difficult behaviors, engagement, assessment, and collaboration strategies; and harm reduction groups. We will focus on these strategies for clients with many different presenting issues. Attention will be paid to how our own reactions to clients can be informative or disruptive to the work. Because this course will have extensive opportunity for skills practice, participants should be prepared to present cases that they would like assistance with (No formal case preparation is required).

THE FUNDAMENTALS OF COMPLEX CLIENTS

July 9, 2012, 9:30 - 5 pm

Trainers: Patt Denning, Jamie Lavender, others

This day will include information about how neurobiology contributes to emotions, behaviors, and how drugs affect our brain. Basic information about the major mental health disorders will be presented, with an emphasis on signs and symptoms as well as a discussion about how psychosis and drugs interact.  Drug, Set, Setting as an assessment model will be demonstrated with cases from the participants.

VULNERABILITY TO MENTAL DISORDERS & DRUG MISUSE

July 10, 2012, 9:30 - 5 pm

Trainers: Perri Franskoviak, Jennifer Plummer, and others

This day will focus on a person’s general vulnerability to developing serious drug and mental health disorders. Topics will include a discussion of the far reaching effects of trauma, the development of personality disorders, and the triad of “emotion, impulse, and action”.  The Developmental Grid as an assessment tool will be presented and demonstrated with cases from the participants.

THE PROCESS OF CHANGE & CLINICAL INTERVENTIONS

July 11, 9:30 - 5 pm

Trainers: Jeannie Little and others

How do people go about making changes in harmful behaviors? This day will focus on the importance of self determination in the development motivation, the stages of change model, and working with the natural ambivalence that people struggle with in making changes. Tools such as the Decisional Balance will be practiced. Participants will also practice using all of the assessment tools discussed in previous days to develop a care plan for their client.

CLINICAL INTERVENTIONS, CONTINUED; MANAGING OURSELVES AND OUR CLIENTS

July 12, 9:30 - 5 pm

Trainers: Perri Franskoviak and Jamie Lavender

Our clients sometimes engage in difficult behaviors that in other situations get them rejected or punished. In harm reduction-informed work, we strive to understand and help the client manage these behaviors in such a way as to keep them engaged in services. A demonstration of a harm reduction group will highlight these issues. Understanding our reactions to the stress of such encounters is key to maintaining a supportive, therapeutic relationship. Examples of interventions for difficult behaviors will be demonstrated. We will also discuss countertransference, vicarious traumatization and strategies for preventing burnout and keeping ourselves balanced, open, and fresh.

CONTINUING EDUCATION UNITS: This course offers 28 hours of continuing education units (CEUs) for California State Certified Addiction Treatment Specialists through the CA Association of Alcohol and Drug Educators, to RNs through the CA Board of Registered Nursing, and LCSW's and MFT's through the CA Board of Behavioral Sciences. We regret we offer no national CEUs at this time.

COST: $250 for all 4 days

THIS 4 DAY INTENSIVE IS OFFERED BY THE STAFF OF THE HARM REDUCTION THERAPY CENTER IN COLLABORATION WITH THE HARM REDUCTION COALITION’S HARM REDUCTION TRAINING INSTITUTE:

 Jeannie Little, LCSW, CGP

Jeannie Little is Executive Director of the Harm Reduction Therapy Center, a nonprofit agency providing harm reduction therapy for drug and alcohol users with complicating emotional, social and health problems.  She is a Licensed Clinical Social Worker and Certified Group Psychotherapist. She has worked in domestic violence and homeless shelters, group homes, homeless drop-in centers and private practice with children, adolescents, families, and dually diagnosed adults since 1978.  In 1993 Ms. Little began developing harm reduction treatment services, beginning at Healthcare for Homeless Veterans, then in private practice and at the Harm Reduction Therapy Center.  She specializes in group treatment of substance use disorders and dual diagnosis.  Ms. Little trains and consults with dozens of mental health, housing, and social service organizations and hundreds of clinicians and other social services staff each year in the areas of harm reduction, dual diagnosis and group work, housing and homelessness.  She is the author of several papers on harm reduction, dual diagnosis, and groups and is co-author of the book Over the Influence: The Harm Reduction Guide for Managing Drugs and Alcohol and of the second edition of Practicing Harm Reduction Psychotherapy.

 Patt Denning, PhD

Patt Denning has worked in Community Mental Health and private practice as a clinician and program director since 1975. She developed specialties in differential diagnosis, psychopharmacology, psychotherapy with seriously disturbed patients, HIV, and substance use disorders. She is one of the primary developers of Harm Reduction treatments. She has written several articles as well as a book for the general public (Over the Influence: The Harm Reduction Guide for Managing Drugs and Alcohol. Guilford Press. ) This book has recently been translated into Chinese. The 2d edition of her first book, Practicing Harm Reduction Psychotherapy was released in the Fall of 2011 (with co-author Jeannie Little). In 2000, she and Jeannie Little created a non-profit treatment and training program, The Harm Reduction Therapy Center (HRTC), which provides a full range of mental health services to dually diagnosed individuals. HRTC also trains hundreds of mental health and substance abuse professionals, outreach workers, homeless advocacy groups, and housing staff each year in this model throughout the United States, Canada, and Asia.

Perri Franskoviak, PhD

Trained as a clinical psychologist, Perri Franskoviak is a senior staff therapist and clinical supervisor at the Harm Reduction Therapy Center. She has been working in community mental health settings for over 20 years, developing and delivering low-threshold treatment services to individuals with mental illness, homelessness, and substance use disorders.  Her areas of interest include trauma and substance use, the integration of harm reduction principles and relational psychotherapy, identifying and working with countertransference, and using supervision as a tool for professional and personal growth.  Dr. Franskoviak also has a small private practice in which she sees individuals with depression, anxiety, trauma, co-occurring disorders, and loss, and has recently undertaken additional training in sensorimotor treatment of trauma.  Dr. Franskoviak trains and consults with several large organizations, including housing and HIV care agencies.  She also trains community police and San Francisco Business District community guides in the management of people with mental illness. She is on the adjunct faculty at several colleges and universities and teaches courses on addiction and treatment, co-occurring disorders, and psychopharmacology.  She is co-author of a paper on harm reduction therapy in community-based settings.

Jennifer Plummer, PsyD

Jennifer Plummer has been working with the Harm Reduction Therapy Center for the past eight years.  She currently works as a therapist, supervisor and community program coordinator at San Francisco Pretrial Diversion: Court Accountable Homeless Services, Hospitality House Sixth Street Self-Help Center Senior Program and at the Homeless Youth Alliance in the Haight Ashbury district of San Francisco.  She has worked in social services for the past 20 years in many capacities and earned her doctorate degree in clinical psychology in 2010.  Dr. Plummer is a psychodynamic practitioner who relies heavily on object-relations theory with a focus on early relational trauma and its impact on the mind.  Her dissertation, In The Arms of Addiction, focuses on the impact of trauma in the lives of injecting heroin users and their subsequent relationship to the needle. 

 Jamie Lavender, MA, MFT

Jamie Lavender is a Licensed Marriage and Family Therapist.  He works as a staff psychotherapist and a community program coordinator with the Harm Reduction Therapy Center, providing individual and group psychotherapy to people with unresolved substance use issues, in low-threshold community mental health settings and private practice.  He provides training and clinical consultation for staff at a variety of community organizations.  He has worked with children and families in schools and family service agencies, with adults navigating the criminal justice system at a jail diversion program, and with opiate users accessing opiate replacement treatment. He is co-author of (along with Little, Hodari & Berg) of Come as you are: Harm Reduction Drop-In Groups for Multi-diagnosed Drug Users.  With a background in transpersonal/integral and somatic psychology, music, and hospice chaplaincy, he uses dreamwork, drumming, and ritual in personal and professional practice. 

Jeremy Rhoades, MA, MFTI

Jeremy Rhoades has nine years of experience in the field of mental health, substance abuse, and HIV. A graduate of John F Kennedy University, Jeremy currently provides bilingual harm reduction therapy to clients at the San Mateo County AIDS program. Jeremy studies nondual psychotherapy in the tradition of Buddhist, explores creative somatic expression and participates in Integral Transformative Practice.