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Motivational Interviewing for HIV Clinicians

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Pacific Southwest ATTC

Pacific Southwest ATTC
10911 Weyburn Avenue., Suite 200
Los Angeles,
HHS Region 9

The Pacific Southwest ATTC, which covers Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Republic of the Marshall Islands, and Republic of Palau, is designed to enhance knowledge of and expertise in providing effective substance use disorder treatment and recovery services by disseminating evidence-based clinical and research information. The Pacific Southwest ATTC develops, revises, and distributes curricula and other resources and products on a variety of SUD topics, and forms partnerships with local and regional stakeholders to ensure that the training and technical assistance needs of the Region are identified and met.

The overarching goals of the Pacific Southwest ATTC are to:

  • Develop an infrastructure to assess the diverse needs of the Region and promote technology transfer of proven treatment and recovery practices
  • Upgrade the standards of professional SUD practice to increase the number, quality, and cultural humility of substance use disorder treatment and recovery practitioners
  • Provide stand-alone and sequenced learning events to help practitioners build their skills to promote systems change and accelerate the adoption and implementation of evidence-based practices
  • Develop scientifically based substance use disorder curricula and encourage academic institutions to train and educate pre-service students and practitioners.

Recent News

From the Pacific Southwest ATTC
Oct. 03, 2023
Leading and Facilitating High Performing Teams in Behavioral Health Settings   ON-DEMAND COURSE   Course Description This 5-module on-demand course focuses on the development of practice competencies for facilitating and leading a variety of meeting formats, activities, and processes to support the deliberative and inclusive actions of organizational teams. These competencies focus on activities for: […]
Aug. 15, 2023
What Providers Needs to Know About Inhalants   The tip sheet provides information on commons types of inhalants, signs of misuse, common slang terms, short-term health effects, a description of Sudden Sniffing Death Syndrome, and treatment options for address inhalant use.   For questions about this tip sheet, please contact Andrew Kurtz, MA, LMFT ([email protected]).
Jun. 08, 2023
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) created brief videos series on a variety of alcohol related topics called Short Takes. Eight videos are available on the National Institute on Alcohol Abuse and Alcoholism (NIAAA) website. The videos are easy to download and put into presentations or post on websites/social media and can be watched on […]

Upcoming Events

Hosted by the Pacific Southwest ATTC
Online Course
Motivational Interviewing Groups: Moving Together Toward Change Motivational interviewing (MI) is an empathic, goal-oriented therapeutic approach that elicits change in health, mental health, and addictive behaviors.  Originally an alternative to addiction approaches that relied on an expert, authoritarian stance in counseling, MI has evolved into a mainstream, evidence-based, and highly-used method for eliciting change that helps people live better and healthier across a wide variety of settings, clinical problems, and populations. MI was developed as an individual approach, focusing on dyadic interactions between the person and the counselor.  However, adapting MI for use with a group of people requires reconceptualizing its core practices to harness the power of group support, cohesion, and momentum.  Group leadership requires skills beyond those in dyadic counseling.  Managing “conversational traffic” and facilitating open sharing among people with different experiences, goals, styles, and beliefs are essential skills for group leaders.  Effective leaders must be well-prepared to address unexpected situations and maintain therapeutic bonds with individual group members while facilitating a conversation among the whole group. This six-session experiential training provides information on adapting MI to groups across a variety of formats, and is highly experiential, leading participants through group practice exercises across the four phases of MI groups.  This series will incorporate evidence-based practices with the MI modality.  Participants will become part of a group, and some will have opportunities to lead the group.  Incorporating Motivational Interviewing group skills developed by the trainers, this series guides participants in successful group leadership, refocusing groups away from rehashing problems and toward inspiring positive change. WHEN: Weekly sessions offered on the same day and start time between May 28 and July 9, 2024 PT. Day and time will depend on your location. Please locate your local time zone in the table below for your weekly start time.   LEARNING OBJECTIVES: At the end of this training experience, participants will be able to: Describe at least two (2) ways to shift from providing individual counseling in a group setting to facilitating group interactions that promote growth and wellness. Specify at least two (2) ways to model a warm, healthy, relaxed, and accepting way of being. Identify at least three (3) strategies to foster a positive group climate while deepening cohesion between members. Assess at least two (2) key elements of the expanded nature of change talk in MI groups. Explain at least two (2) ways to broaden and deepen group conversations for optimal success. Compare at least three (3) strategies to transform group conflict into moments of growth. Specify at least three (3) guided group activities such as exploring values, drawing from past successes, harnessing personal strengths, and envisioning a better future. Design a plan to utilize the three (3) MI strategies of Exploring and Broadening Perspectives, Building Momentum for Change, and Moving into Action. INTENDED AUDIENCE: Behavioral health, substance use disorder, and recovery service providers located in the Pacific Southwest ATTC region (HHS Region 9) Preferably have experience in or access to facilitating groups PARTICIPANT COMMITMENT & EXPECTATIONS To be eligible and register for this series, applicants are required to first complete either (1) an Intro to MI live virtual or face-to-face training offered by the PSATTC or (2) the 4-hour, free self-paced, online course Tour of MI: An Interprofessional Road Map for Behavior Change and submit the electronic copy of your certificate of completion from either of these trainings during the registration process Access to appropriate technology to utilize Zoom videoconferencing platform (internet connection, webcam, laptop/tablet, speakers and microphone) Attend a one-hour online Orientation on May 28, 2024 (refer to chart above for scheduled dates/times in your time zone) Commit to 6-weeks of online training: 5 hours sessions on scheduled series days/time and complete 1.0 hour of weekly self-study learning activities Be prepared and actively engage while on camera 90% of the scheduled series time TRAINER(S)/FACILITATOR(S): Kate Speck, PhD, MAC, LADC Paul Warren, LMSW Amy Shanahan, MS, CADC THERE IS NO COST TO PARTICIPATE: The first 35 registrants will receive a waiver that covers the $350 cost to participate. Once the 35 spots have been filled, registration will be closed. Due to limited enrollment, if you cannot commit to the full requirements, please defer this opportunity to others. Please Note: Registrants enrolled in this series are expected to attend the first TWO sessions. In addition, it is expected that participants will have access to the appropriate technology by Week 2 to fully participate and be on camera at least 90% of the time. This is not a webinar series and active participation to gain/improve skills are required. CONTINUING EDUCATION (CEs/CEHs) This series has been approved for a total of 16 contact hours through the National Association for Addiction Professionals (NAADAC), International Certification & Reciprocity Consortium (IC&RC), and the National Board for Certified Counselors (NBCC) ACEP No. 6492. UCLA Integrated Substance Abuse Programs (ISAP) is approved by the American Psychological Association to sponsor continuing education for psychologists. UCLA ISAP maintains responsibility for this program and its content. UCLA ISAP is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LCSWs, LPCCs, and/or LEPs (Provider #64812). UCLA ISAP maintains responsibility for this program/course and its content. Course meets the qualifications for up to sixteen (16) hours of continuing education credits for LMFTs, LCSWs, LPCCS, and LEPs as required by the California Board of Behavioral Sciences. UCLA ISAP is also an approved provider of continuing education for RADTs I/II, CADCs-CASs, CADCs I/II, CADCs-CSs, and LAADCs (CCAPP, #2N-00-445-1125), CATCs (ACCBC/CAADE, #CP40 872 C 0825), and CAODCs (CADTP, #151). Provider approved by the California Board of Registered Nursing, Provider #15455, for up to 16 contact hours. UNR CASAT is an approved provider of continuing education credit for NCACs I/II and MACs through the National Association of Alcoholism and Drug Abuse Counselors (NAADAC, #98165). This program is approved by the Hawaii State Department of Health’s Alcohol and Drug Abuse Division (ADAD-AP24-004) for 16.0 education content hours (CPS, CSAC, CCJP, CCS, and CSAPA). CE credit will be awarded at the conclusion of the series for full-session participation. Partial credit will not be available for those participants who arrive at any particular session late or leave early. Make-up work will not be provided or accepted. QUESTIONS: Please contact the NFARtec Workwise Staff at [email protected] or by phone at 775-784-6265 or 866-617-2816 (toll-free).

Products & Resources

Developed by the Pacific Southwest ATTC
Curriculum Package
Discover the Benefits of DBT for Individuals in Substance Use Disorder Recovery   Dialectical Behavioral Therapy (DBT) has emerged as a powerful evidence-based approach to addressing the complexities of substance use disorders, offering a comprehensive toolkit that extends beyond conventional methods. In this six-hour training, participants will delve into the core principles and techniques of DBT, exploring how they enrich SUD treatment by fostering mindfulness, enhancing interpersonal skills, regulating emotions, and bolstering distress tolerance. This training package includes a 6-hour PowerPoint presentation (full curriculum) and a 13-page handout packet. There are various options for presenting the 6 hours of content, including through a 1, 2, or 3-hour workshop, a single full-day (6-hour) training session, or two 3-hour sessions, which allows for convenient scheduling while maintaining satisfactory coverage of the material. All materials contained in this training package are 508 compliant.   Learning Objectives: At the end of this training, participants will be able to: Distinguish two (2) specific behaviors that DBT is designed to treat and the origins of DBT Describe the four (4) groups of skills utilized in DBT (Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance) Identify two (2) ways in which DBT skills can be useful for substance use disorders Apply one (1) specific DBT Skill pertaining to one of the four (4) DBT skills Explain two (2) specific ways in which DBT can be integrated into an SUD treatment setting In-Depth Description of Training:  Originally developed to address chronic suicidal ideation and borderline personality disorder (BPD), DBT blends cognitive behavioral therapy (CBT) with a dialectical philosophy, emphasizing acceptance and change simultaneously. Over time, research has shown its effectiveness in treating a spectrum of mood disorders including depression, post-traumatic stress disorder (PTSD), eating disorders, and importantly, substance use disorders. This training explores how DBT goes beyond its original purpose, becoming a pivotal intervention in reshaping behavioral patterns and becoming a crucial tool in reshaping behaviors, particularly concerning substance misuse. Through this structured curriculum, participants will gain insights into the four core skill sets (modules) of DBT: Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. Throughout this training, participants will examine the nuanced ways in which each skill set intertwines with SUD treatment, promoting a holistic approach toward recovery. Mindfulness, as the cornerstone of DBT, encourages individuals to embrace the present moment, detaching from harmful thought patterns and impulses. Interpersonal Effectiveness skills equip individuals with strategies for building healthy relationships, crucial in navigating support networks during recovery journeys. Emotion Regulation skills teach mechanisms for managing intense feelings, providing tools to modulate emotional responses without resorting to substance use, while distress tolerance skills empower individuals to withstand cravings and urge to use, fostering resilience in recovery. Moreover, this training underscores the importance of DBT in addressing co-occurring mental health disorders, breaking down barriers to recovery, and promoting sustained abstinence from substances. By fostering engagement, trust, and collaboration, DBT sets the stage for long-term success, enabling individuals to reclaim agency over their lives and forge a path toward lasting wellness. In summary, this six-hour training serves as a roadmap towards integrating DBT principles into SUD treatment, equipping participants with the knowledge and skills necessary to effect transformative change in the lives of those grappling with substance misuse.
  Leading and Facilitating High Performing Teams in Behavioral Health Settings   ON-DEMAND COURSE   Course Description This 5-module on-demand course focuses on the development of practice competencies for facilitating and leading a variety of meeting formats, activities, and processes to support the deliberative and inclusive actions of organizational teams. These competencies focus on activities for: conducting efficient and effective meetings, developing team comrade and trust, generating information, generating and evaluating ideas, making decisions, and developing action plans. This course is designed to provide you with a set of tools and practices that will enhance your leadership and facilitation effectiveness within various behavioral health settings. In these settings, behavioral health providers may be part of one or more ongoing or ad hoc work-place clinical teams or committees (discharge committee; high utilizer committee) and organizational work-place meetings (shift change, staff meetings). In today’s post-COVID world, many organizational teams operate both virtually and in-person.   TO VIEW AND COMPLETE MODULES 1, 2, 3, 4, and 5  PLEASE VISIT:   Structure of the Course This on-demand course is divided into five (5) modules. Each module will take one (1) hour to complete and learners can receive one (1) continuing education (CE) credit/contact hour for completing each module. Each module will require you to view 2-3 brief video lectures, read brief articles or other informational documents, and complete 1 application activity. The five (5) modules consist of:    
Print Media
  Treatment for Individuals who Use Stimulants TRUST A Protocol Using Empirically-Supported Behavioral Treatments for People with Stimulant Use Disorders     Purpose of the TRUST-MAIN Manual The authors of this manual have been involved in StimUD-related research, treatment, and training efforts for over 30 years. Over this period, the research on StimUD and its treatment has vastly increased and there is a great interest in better understanding StimUD and providing effective treatment for people who use cocaine and methamphetamine. We have produced this manual to promote the use of research-supported strategies for StimUD treatment. The manual attempts to combine a number of strategies into a framework that is appropriate for use by clinicians in settings where people with StimUD receive treatment. This manual is not intended to be a cookbook and the materials used and the framework for their use are not intended to be an inflexible, one-size-fits-all prescription. At the end of the manual, we list a variety of treatment materials (see Appendix) that can be added or substituted for the ones we are recommending. We provide the contents of this manual and the framework for combining these treatment materials as one example for how research-supported strategies can be combined into a structured treatment experience. The manual was developed at a time when CM with adequate incentives was considered impossible in the U.S. Hence, this manual was produced to offer a possible, albeit a non-evidence-based and certainly less effective alternative to CM. As evidence-based CM protocols using adequate incentives are increasingly being developed and implemented in the U.S., there is interest in having CM delivered within a framework of other evidence-based behavioral support. The use of the materials in the TRUST Manual to augment CM treatment is another possible use of the manual, either in the form of a 12-week framework, or as ad hoc behavioral support materials. The audience for the manual includes healthcare professionals who provide treatment services for individuals with StimUD. One category of these professionals who we particularly hope will benefit are therapists and other behavioral health clinicians who work in substance use disorder specialty care treatment programs. The manual has been written with this group in mind.   The manual intends to: Provide new information about the use and effects of cocaine and methamphetamine. Present several key clinical challenges that clinicians face when treating this population. Review the evidence-based treatment strategies for StimUD treatment. Discuss how motivational interviewing (MI) is central to the effective engagement of individuals in treatment and to assisting them with behavior change during treatment. Present how elements of community reinforcement approach (CRA) and cognitive behavioral therapy (CBT) can be used to assist individuals with StimUD to reduce/discontinue their drug use and prevent relapse. Describe a procedure for incorporating positive incentives into the treatment milieu and/or support the use of CM for the treatment of StimUD. Provide information and guidance for how physical exercise can benefit individuals who are attempting to reduce/discontinue their use of methamphetamine and cocaine. Describe a plan for providing continuing care to assist individuals to sustain the progress they have made in a structured treatment program. List an array of manuals and training resources for other research-supported substance use disorder treatment approaches.   For those working with people receiving care for Opioid Use Disorder, an adapted version is available Treatment for Individuals who Use Stimulants while on MOUD TRUST—MOUD THERAPIST MANUAL & PATIENT WORKBOOK       Purpose of the TRUST-MOUD Manual The TRUST MOUD Manual is intended to be used with patients who are struggling with stimulant (cocaine/amphetamine) use while in treatment for OUD with methadone, buprenorphine, or naltrexone. Working with patients presenting in MOUD treatment is a challenging, yet incredibly rewarding experience. While it is rewarding, it can also be frustrating. Stimulant use among these patients is common and many patients don’t see their use as problematic. In fact, for some patients who use stimulants sporadically, they may not need treatment. But certainly, for some patients on MOUD, cocaine/meth use is extremely detrimental to the effectiveness of their MOUD treatment and is a serious health problem. However, in many cases, regardless of the severity of use, the patients often don’t recognize their stimulant use as a problem, and they are not interested in intensive treatment. The materials in the TRUST MOUD Manual attempt to provide this patient population with a useful set of information in a format that they find acceptable. The materials adopt CRA, CBT, and MI content and present it in a clear and relevant form that addresses the challenges they face while in MOUD treatment. We try to avoid long, didactic, lecturing materials, but rather try to create accessible topics and examples. TRUST was developed with flexibility in mind to optimize patient engagement and retention. TRUST materials can be presented in 1:1 sessions and can be scheduled with patients or in on-going stimulant treatment groups. Topics can be presented in a sequence and frequency that lets therapists select content to meet patient needs. The 24 TRUST worksheets can be used in a flexible manner to be relevant and useful to patients. Consistency is important when using the TRUST Manual. Set and adhere to meeting days and times. Start and end sessions on time. If used in a group format, have some group participation guidelines. Adhering to a specific session format and timing will enhance patients’ understanding of the group/individual session process and will allow them to focus on acquisition of new material. Patients using stimulants will undoubtedly experience cognitive impairment as they participate in sessions and utilize the TRUST materials. Slowing down to allow patients to gather their thoughts and express themselves during group or individual sessions is important. In addition, using multi-media and repetition can be helpful for patients to grasp new concepts. Use of Motivational Interviewing as a fundamental style and interpersonal approach is essential to success when using TRUST materials. Ideally, TRUST session attendance should be paired with medication visit attendance to reduce the travel burden on patients. This is especially true in rural areas, where public transportation is non-existent, or when a patient has employment, education, or homemaking responsibilities. When possible, patients should have an opportunity to determine therapy visit days and times based upon their scheduling needs. Research has shown that aerobic exercise improves cognitive capacity, reduces depression and anxiety, and improves cardiac and pulmonary function for individuals with stimulant use disorder. Several of the TRUST worksheets discuss the benefits of exercise as part of a treatment effort to reducing stimulant use. Encouraging patients to exercise will also help them to manage emotional highs and lows and help them structure their day. Getting patients to exercise is often difficult and requires ongoing encouragement and support. The TRUST materials and their use with patients on MOUD should be used with a strong harm reduction foundation. The #1 priority for this group of patients is retention in treatment with MOUD. Participation in treatment activities with TRUST materials, when appropriate, should be encouraged, rewarded, and praised. In our opinion, requiring treatment attendance with TRUST materials, with a threat of MOUD discontinuation is never justified. In an era of lethal drugs including fentanyl, retention on MOUD is essential. Other harm reduction activities should be combined with TRUST materials. Access to safe injection supplies, ready access to naloxone and fentanyl test strips, and as new drugs emerge (e.g., xylazine), it is critical to provide new information and test strips as they become available. Many patients in MOUD treatment have multiple life challenges, including use of numerous drugs and alcohol, food insecurity, being unhoused, unemployment, as well as both mental health and physical health issues. To be successful, patients will need to be retained in treatment for a significant period of time, if not for a lifetime. These issues are not going to be resolved overnight, but rather through consistent and prolonged effort. We hope these materials can be useful to your work with patients on MOUD.   Authors Richard Rawson, PhD Richard A. Rawson, PhD, is Professor Emeritus at the UCLA Department of Psychiatry and a Research Professor at the Vermont Center for Behavior and Health at the University of Vermont. He received a Ph.D. in experimental psychology from the University of Vermont in 1974. Dr. Rawson conducted numerous clinical trials on pharmacological and psychosocial addiction treatment and extensive system evaluation activities in a number of states and countries. He has led addiction research and training projects for the United Nations, the World Health Organization, and the U.S. State Department, exporting science-based knowledge to many parts of the world. Dr. Rawson has published 3 books, 40 book chapters, and over 250 peer-reviewed articles and has, for almost 50 years, conducted workshops, paper presentations, and training sessions in many areas of the world.   Albert Hasson, MSW Albert L. Hasson received his MSW from UCLA and has worked in the field of addiction medicine as a researcher and a treatment provider since 1977. Mr. Hasson participated in the development of the evidence-based Matrix Model, a cognitive behavioral intervention for StimUD Treatment, and established the Matrix Institute on Addictions, Los Angeles opioid treatment program. Along with his administrative and clinical experience, Mr. Hasson has extensive experience in implementing and evaluating behavioral and pharmacologic interventions. He has served as a project director and trainer for the Pacific Southwest Addiction Technology Transfer Center at the UCLA Integrated Substance Abuse Programs.   Janice Stimson, PsyD Janice Stimson, PsyD, has worked in the field of addiction treatment since 1998. For 20 years she has worked at the Matrix Institute on Addictions in the role of Clinic Director, overseeing and managing the clinic, seeing clients and supervising staff. At the clinic private adolescent and adult treatment programs coexisted along-side national research studies. Dr. Stimson held key positions in those studies and was responsible for ensuring the success of fulfilling recruitment, training, supervision, and protocol requirements.   Michael McCann, MA Michael McCann, M.A., is one of the founders of the Matrix Institute on Addictions and creators of the Matrix Model. He has overseen the operation of Matrix clinics as well as the integration of many research projects within these sites. He has over 40 years of experience in substance use disorder treatment and research, and has authored or co-authored over 40 articles, books, and manuals. He has trained and lectured extensively on evidence-based behavioral interventions, pharmacologic treatments, methamphetamine dependence, opioid dependence, and on the implementation of evidence-based treatments into clinical practice   Acknowledgements The authors would like to acknowledge the assistance provided by Thomas E. Freese, PhD, Beth Rutkowski, MPH, Gloria Miele, PhD, and Valerie P Antonini, MPH. Christine Morgan provided invaluable support with the production of the manual, along with editing support from Victoria T. Norith and Benjamin Nguyen, MSW, CPH. The materials in this manual include content and worksheets from the Matrix Model Therapist Manual (SAMHSA, 2006); from the Community Reinforcement Approach, plus Vouchers Manual (NIDA, 2020).
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