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Case Consult Program

Case Consult Program. Cummins Behavioral Health Systems August 2013 Doris Ryan, Ph.D., HSPP. Purpose of Program. Review treatment for cases with high usage of services Examine what’s going on when there are many crisis calls, hospitalizations, and/or a large number of services

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Case Consult Program

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  1. Case Consult Program Cummins Behavioral Health Systems August 2013 Doris Ryan, Ph.D., HSPP

  2. Purpose of Program Review treatment for cases with high usage of services Examine what’s going on when there are many crisis calls, hospitalizations, and/or a large number of services Create an additional way for treatment teams to get assistance in difficult situations

  3. More Purposes Provides treatment for the treatment team – how are we getting stuck? An outgrowth of the “consultation team” concept in DBT

  4. Typical Cases Used this with about 10 cases in the last year Consumers about evenly divided between male and female From 4 different offices Ranging in age from 20 to 50 Common denominator: personality issues

  5. Common Patterns • Personality issues plus: • Substance abuse • Serious health problems • Lack of family stability and support • Intermittent psychosis • Lots of complexity!

  6. Consultation Process • Starts with a call from the treatment team • First step is a chart review by the consultant • Second step is a meeting of team with consultant to clarify information – consumer not present • Then some options: • Make recommendations to team, check back later with them • Meet regularly, weekly at first, to coach • Provide training to team members

  7. Team Issues to Address • What outcome fits with consumer needs and abilities? • Cure • Amelioration of the consumer’s problems • Improvement inone problem • Behavioral management of the problems • Referral to more appropriate services (from Greg Lester, “Personality Disorders in Social Work and Health Care”)

  8. …. More Team Issues Recognizing drama versus talk and its relation to treatability Dealing with the team’s motivation to treat more Addressing the current“stage of change” Creating a common basis of knowledge in the team Addressing team’s information and skill needs Getting realistic about how long change takes

  9. Success Means Roadblocks Were Resolved • Some of the outcomes: • Ongoing consultation teams for two consumers – crisis calls and hospitalizations reduced • Re-involved one consumer in his treatment after a substance abuse relapse • One consumer and family started working harder in treatment because of the team interest • Arrangement of more appropriate treatment when needed

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