This document provides information about working with pathological gambling and mania. It defines the criteria for a manic episode according to the DSM-4, including symptoms such as elevated mood, decreased need for sleep, distractibility, and risky behavior. It notes that gambling during a manic episode may be attributed to the episode, but gambling outside of episodes suggests both conditions. The document also defines personality disorders and lists their prevalence in pathological gambling patients. It provides descriptions and criteria for specific personality disorders like narcissistic personality disorder. An exercise case study is included about working with a client named Robert who displays narcissistic traits. Outcome measures for evaluating gambling treatment are discussed.
The document discusses co-existing mental health and substance use problems. It notes that co-existing problems are common, with high rates of substance use disorders occurring alongside mood and anxiety disorders. Having co-existing problems leads to more severe and treatment-resistant issues. Screening and assessment tools are recommended to help identify and classify co-existing problems. An integrated treatment approach is needed that addresses both the substance use and mental health issues. Cultural factors are also important to consider in assessment and treatment of co-existing problems.
Mental health is better supported through community and citizenship rather than services alone. Current systems focus too much funding on services instead of improving social inclusion. Personalized support and strengthening communities could lead to better long-term mental health outcomes compared to traditional treatment models.
Describe and Define Standard of Care & Ethics
Describe and Define Laws
Identify Top Ethical Issues visa vie Snowball Sample
Recommend Ethical Decision
Making Models
CARE Challenge Providers to Develop Mission, and Ethics Statements for Behavioral Health Care Centers
The document discusses medications for mental illness in adolescents. It covers topics like side effects, time to onset of effects, monitoring medication effectiveness and safety, and tools/resources for patients and providers. The presentation addresses prevailing attitudes toward psychotropic medications in youth and promotes education on proper medication use and monitoring to promote mental wellness. Resources for further information on mental health medications are also provided.
iCAAD London 2019 - Clarinda Cuppage and Lou Lebentz - NUMBING THE PAIN: CHI...iCAADEvents
Childhood sexual abuse (CSA) has seemed at the forefront of many news items recently and increasingly out there in the public domain. The statistics quoted in the UK are 1 in 4 women and 1 in 6 men are survivors, higher in other countries such as the USA. Indeed, most of our addiction clients tend to present with underlying trauma, many as a result of CSA. So as clinicians and treatment providers how do we deal with this epidemic in terms of numbers and the resultant increased disclosures and presentations?
This document discusses co-occurring addiction and mental health disorders, also known as dual diagnosis. It begins by defining dual diagnosis as having two diagnoses or disorders that involve both mental health and addiction systems. Examples of common dual diagnoses include schizophrenia, bipolar disorder, depression, PTSD, or social anxiety combined with substance use disorders involving alcohol, cocaine, opioids, or marijuana. The document then discusses characteristics of clients with dual diagnoses and challenges involving different treatment systems, laws, funding sources, and approaches between mental health and addiction fields. It emphasizes the importance of considering dual diagnoses beyond only severe mental illnesses and also in other contexts like addiction treatment centers, criminal justice settings, and primary care.
The document summarizes statistics and research on gambling and gambling addiction. It notes that 85% of Americans have gambled, with 65-80% gambling in the past year. Problem gambling is defined as an urge to gamble despite negative consequences. Pathological gambling is a clinical diagnosis involving uncontrollable gambling behavior. Research suggests genetic and neurological factors, like imbalances in dopamine and serotonin, may contribute to gambling addiction. Treatments include counseling, support groups, and some medications.
iCAAD London 2019 - Stefanie Carnes - SEXUALLY COMPULSIVE AND ADDICTIVE BEHA...iCAADEvents
In recent years there has been tremendous controversy about sexually compulsive behaviour. Researchers and clinicians alike have argued about the best terminology to use, diagnostic criteria, and treatment approaches. In this presentation, Dr. Carnes discusses the concerns about labelling out control sexual behaviour and examines the new research and the controversy surrounding the diagnosis. Different perspectives on conceptualisation of the disorder and treatment will be discussed.
The document discusses co-existing mental health and substance use problems. It notes that co-existing problems are common, with high rates of substance use disorders occurring alongside mood and anxiety disorders. Having co-existing problems leads to more severe and treatment-resistant issues. Screening and assessment tools are recommended to help identify and classify co-existing problems. An integrated treatment approach is needed that addresses both the substance use and mental health issues. Cultural factors are also important to consider in assessment and treatment of co-existing problems.
Mental health is better supported through community and citizenship rather than services alone. Current systems focus too much funding on services instead of improving social inclusion. Personalized support and strengthening communities could lead to better long-term mental health outcomes compared to traditional treatment models.
Describe and Define Standard of Care & Ethics
Describe and Define Laws
Identify Top Ethical Issues visa vie Snowball Sample
Recommend Ethical Decision
Making Models
CARE Challenge Providers to Develop Mission, and Ethics Statements for Behavioral Health Care Centers
The document discusses medications for mental illness in adolescents. It covers topics like side effects, time to onset of effects, monitoring medication effectiveness and safety, and tools/resources for patients and providers. The presentation addresses prevailing attitudes toward psychotropic medications in youth and promotes education on proper medication use and monitoring to promote mental wellness. Resources for further information on mental health medications are also provided.
iCAAD London 2019 - Clarinda Cuppage and Lou Lebentz - NUMBING THE PAIN: CHI...iCAADEvents
Childhood sexual abuse (CSA) has seemed at the forefront of many news items recently and increasingly out there in the public domain. The statistics quoted in the UK are 1 in 4 women and 1 in 6 men are survivors, higher in other countries such as the USA. Indeed, most of our addiction clients tend to present with underlying trauma, many as a result of CSA. So as clinicians and treatment providers how do we deal with this epidemic in terms of numbers and the resultant increased disclosures and presentations?
This document discusses co-occurring addiction and mental health disorders, also known as dual diagnosis. It begins by defining dual diagnosis as having two diagnoses or disorders that involve both mental health and addiction systems. Examples of common dual diagnoses include schizophrenia, bipolar disorder, depression, PTSD, or social anxiety combined with substance use disorders involving alcohol, cocaine, opioids, or marijuana. The document then discusses characteristics of clients with dual diagnoses and challenges involving different treatment systems, laws, funding sources, and approaches between mental health and addiction fields. It emphasizes the importance of considering dual diagnoses beyond only severe mental illnesses and also in other contexts like addiction treatment centers, criminal justice settings, and primary care.
The document summarizes statistics and research on gambling and gambling addiction. It notes that 85% of Americans have gambled, with 65-80% gambling in the past year. Problem gambling is defined as an urge to gamble despite negative consequences. Pathological gambling is a clinical diagnosis involving uncontrollable gambling behavior. Research suggests genetic and neurological factors, like imbalances in dopamine and serotonin, may contribute to gambling addiction. Treatments include counseling, support groups, and some medications.
iCAAD London 2019 - Stefanie Carnes - SEXUALLY COMPULSIVE AND ADDICTIVE BEHA...iCAADEvents
In recent years there has been tremendous controversy about sexually compulsive behaviour. Researchers and clinicians alike have argued about the best terminology to use, diagnostic criteria, and treatment approaches. In this presentation, Dr. Carnes discusses the concerns about labelling out control sexual behaviour and examines the new research and the controversy surrounding the diagnosis. Different perspectives on conceptualisation of the disorder and treatment will be discussed.
The document describes the roles and responsibilities of the P.A.C.T. mental health team in the north region, which is led by Michelle Loury and responds to individuals in mental health crises through assessments, referrals, treatment, and 6 month follow ups. It provides details on how the team operates, the types of issues they see, and their process for assessing and supporting clients in various locations throughout the community.
London iCAAD 2019 - Sarah Flowers and Charlotte Parkin - PSYCHEDELIC ASSISTED...iCAADEvents
What does the future hold for abstinence-based recovery? There is new wave of medication on the horizon to treat addiction which includes the psychedelics: ketamine, MDMA & psilocybin. Currently in the UK there are mainstream clinical trials in which alcoholics are treated with MDMA. In 2021 this will be a licensed treatment and may be much more widely available option.
iCAAD London 2019 - Dr Stefanie Carnes - COMPLEX TRAUMA IN WOMEN WITH COMPULS...iCAADEvents
Complex Trauma in Women with Compulsive and Addictive Sexual Behaviour Often compulsive and addictive behaviour is thought of as a male problem, however, more and more women are coming forward struggling with the behaviour.
Identifying and Treating Individuals and Families Experiencing Early and Acut...Sarah Amani
The main objective of this online workshop was to raise awareness about symptoms of psychosis and how to support individuals and families experiencing prodrome, early and acute psychosis in different settings ranging from primary care, community mental health and acute hospital
The document discusses a presentation given by three occupational therapy students on depression in older adults. It begins with introducing the presenters and their backgrounds and qualifications. The presentation objectives are then outlined, which are to define key terms related to occupational therapy and depression, discuss symptoms and causes of depression, explain how occupational therapy can help those with depression, and describe the Geriatric Depression Scale assessment tool. The bulk of the document provides details on these topics, explaining concepts like occupational therapy, depression, the populations occupational therapists work with, and how the Geriatric Depression Scale is used to screen for depression in older adults.
Working with schizophrenia, bipolar & substance misuse september 2015Patrick Doyle
The document provides information about a 2-day training course on working with individuals experiencing schizophrenia, bipolar disorder, and substance misuse. The course objectives are to develop understanding of these conditions, explore best practices for engagement, and promote inclusion. The document outlines the agenda, which includes introductions, learning about symptoms and treatments for schizophrenia in the first part, and a discussion of dual diagnosis and mental health/substance misuse links.
This document provides an overview of psychosis and psychotic disorders, their symptoms, and treatment including psychotropic medications. It discusses key psychotic symptoms like hallucinations, delusions, and thought disorders. It also outlines several psychiatric disorders that involve psychosis such as brief reactive psychosis, schizophrenia, and schizoaffective disorder. The document reviews treatment approaches for psychosis including supportive psychotherapy, cognitive behavioral therapy, and the use of psychotropic medications like antipsychotics.
ARGEC Module: Assessment of Geriatric Depression Finalkwatkins13
This document provides an overview of geriatric depression, including prevalence rates, risk factors, cultural considerations, symptoms, differential diagnosis, and assessment tools. Some key points:
- Depression affects 15-13% of older adults, with higher rates among nursing home residents (54.4%). Risk factors include disability, cognitive impairment, poor health, bereavement and loneliness.
- Cultural factors like race, ethnicity and gender impact presentation and treatment. Assessment considers atypical symptoms like somatic complaints and involves screening tools like the PHQ-9 or GDS.
- Differential diagnosis distinguishes depression from conditions like dementia, delirium, medical illness and medication side effects. Multiple assessment instruments are highlighted for their validity
Zoned, Stoned And Blown Pain Psych R X And C D Cady At OliverLouis Cady, MD
Review by Louis B. Cady, MD (Cady Wellness Institute) of the interdigitation between psychiatric disorders, chemical dependency and issues in treatment and recovery. This presentation reviews the enormous intertwinement between untreated ADHD and the development and maintenance of substance use and chemical dependency, examining both biological and psychodynamic influences. It concludes with tips from the recovery community and recommendations on how treatment teams can collaborate with each other.
Dr. Michael Wohl - Advances in Motivating Change Among Disordered Gamblers: W...Horizons RG
Dr. Michael Wohl - Advances in Motivating Change Among Disordered Gamblers: Why and How Memories of the Past Self Can Facilitate Motivation to Engage in Behavioural Change
Presented at the New Horizons in Responsible Gambling Conference in Vancouver, February 2-4, 2015
iCAAD London 2019 - Dr Alberto Pertusa - Addiction treatment: What new medica...iCAADEvents
In this presentation, Consultant Psychiatrist and international addictions specialist, Dr McPhillips, will provide an overview of emerging medical treatments for addiction and Dr Pertusa will discuss ADHD & addiction.
This document provides information on helping elderly friends and family who may be depressed. It defines depression, lists common causes in the elderly like loneliness or illness, and signs to watch for like changes in mood or appetite. It recommends offering social support, encouraging activities, and seeing a doctor. Senior centers in the area are listed that can help connect seniors to programs, healthcare, and each other. A quiz called the Geriatric Depression Scale is included to help assess depression risk in the elderly.
This document provides an overview of post-traumatic stress disorder (PTSD) including its biology and management. It discusses the neurobiology of PTSD and how trauma affects the brain. Key points include:
- PTSD is an anxiety disorder that develops after a traumatic event and is characterized by re-experiencing, avoidance, mood/cognition changes, and arousal.
- Neuroimaging shows decreased hippocampal volume and hyperactivity in the amygdala in those with PTSD, reflecting altered stress responses.
- The hypothalamus-pituitary-adrenal axis is sensitized in PTSD, leading to low cortisol levels despite high corticotropin-releasing factor in the brain.
Au Psy492 Week7 As2 Elderly Depression Davenportsaradavenport
This document discusses depression in older adults and the need for better diagnosis and treatment. It notes that the population of older adults is growing rapidly but mental health treatment rates are low. Several factors that influence depression are examined, including social connections, religion, physical health, and therapies like meditation. The literature review covers topics like misdiagnosis by primary care physicians, effects of gender and marital status, impacts of aging on the brain, and religion's relationship to well-being. The conclusion calls for more research on accurate diagnosis, treatment options, and strategic planning given the aging population.
This document discusses problem gambling screening, brief intervention, and referral to treatment. It begins with an overview and definitions of key gambling-related terms. It then reviews changes to gambling disorder diagnosis in the DSM-5 and evidence that screening for gambling problems is important given high rates of co-occurring disorders. Common screening tools are identified like the SOGS and NODS. The document closes with a discussion of health and social impacts of problem gambling like increased medical costs and intimate partner violence.
This document provides guidance for psychiatrists on assessing patients, including conducting psychiatric histories, mental state examinations, cognitive assessments, and evaluating for depression. It outlines tools and areas of focus for gathering a patient's identity, present complaint, personal history, mental state, physical examination, clinical assessment, and screening for cognitive impairment and depression. Specific assessment tools are described for evaluating cognition, memory, depression in various populations, suicidal ideation, spirituality, resilience, parenting skills and family functioning for patients of different ages.
This document provides information about ADHD medications for teachers, including:
- Stimulant and non-stimulant medications are the main treatment options for ADHD.
- Medications can help improve attention span, reduce hyperactivity, and improve impulse control.
- Potential adverse effects include reduced appetite, insomnia, stomach aches, and irritability."
Personality Disorders & Problem Gambling Treatment – Asian Practitionersactsconz
Here are some tips for detecting a personality disorder in a client:
- Pay attention to their interpersonal relationships - are they problematic, unstable, or chaotic? This could indicate Cluster B PDs.
- Look for rigid, maladaptive coping patterns. Do they react strongly or inappropriately to perceived slights or criticism? This could point to Cluster A or B.
- Assess their moods - are they unstable, dramatic shifts in emotion? Again, this suggests Cluster B.
- Consider their self-image. Do they have distorted, unstable or fragile self-image? This is common in Cluster B PDs.
- Take a developmental history. Did problems start in childhood or adolescence? PD
Problem Gambling: Key Issues for Behavioral Health ProvidersJulie Hynes
This document provides an overview of key considerations for behavioral health providers regarding gambling. It defines gambling disorder according to the DSM-5, discusses prevalence rates and at-risk populations. It explores connections between gambling disorder and mental health/substance use conditions. The document outlines typical phases of problem gambling and how gambling activates the brain's reward system similarly to drugs. It provides details about gambling treatment options in Oregon including outpatient and residential programs.
The document describes the roles and responsibilities of the P.A.C.T. mental health team in the north region, which is led by Michelle Loury and responds to individuals in mental health crises through assessments, referrals, treatment, and 6 month follow ups. It provides details on how the team operates, the types of issues they see, and their process for assessing and supporting clients in various locations throughout the community.
London iCAAD 2019 - Sarah Flowers and Charlotte Parkin - PSYCHEDELIC ASSISTED...iCAADEvents
What does the future hold for abstinence-based recovery? There is new wave of medication on the horizon to treat addiction which includes the psychedelics: ketamine, MDMA & psilocybin. Currently in the UK there are mainstream clinical trials in which alcoholics are treated with MDMA. In 2021 this will be a licensed treatment and may be much more widely available option.
iCAAD London 2019 - Dr Stefanie Carnes - COMPLEX TRAUMA IN WOMEN WITH COMPULS...iCAADEvents
Complex Trauma in Women with Compulsive and Addictive Sexual Behaviour Often compulsive and addictive behaviour is thought of as a male problem, however, more and more women are coming forward struggling with the behaviour.
Identifying and Treating Individuals and Families Experiencing Early and Acut...Sarah Amani
The main objective of this online workshop was to raise awareness about symptoms of psychosis and how to support individuals and families experiencing prodrome, early and acute psychosis in different settings ranging from primary care, community mental health and acute hospital
The document discusses a presentation given by three occupational therapy students on depression in older adults. It begins with introducing the presenters and their backgrounds and qualifications. The presentation objectives are then outlined, which are to define key terms related to occupational therapy and depression, discuss symptoms and causes of depression, explain how occupational therapy can help those with depression, and describe the Geriatric Depression Scale assessment tool. The bulk of the document provides details on these topics, explaining concepts like occupational therapy, depression, the populations occupational therapists work with, and how the Geriatric Depression Scale is used to screen for depression in older adults.
Working with schizophrenia, bipolar & substance misuse september 2015Patrick Doyle
The document provides information about a 2-day training course on working with individuals experiencing schizophrenia, bipolar disorder, and substance misuse. The course objectives are to develop understanding of these conditions, explore best practices for engagement, and promote inclusion. The document outlines the agenda, which includes introductions, learning about symptoms and treatments for schizophrenia in the first part, and a discussion of dual diagnosis and mental health/substance misuse links.
This document provides an overview of psychosis and psychotic disorders, their symptoms, and treatment including psychotropic medications. It discusses key psychotic symptoms like hallucinations, delusions, and thought disorders. It also outlines several psychiatric disorders that involve psychosis such as brief reactive psychosis, schizophrenia, and schizoaffective disorder. The document reviews treatment approaches for psychosis including supportive psychotherapy, cognitive behavioral therapy, and the use of psychotropic medications like antipsychotics.
ARGEC Module: Assessment of Geriatric Depression Finalkwatkins13
This document provides an overview of geriatric depression, including prevalence rates, risk factors, cultural considerations, symptoms, differential diagnosis, and assessment tools. Some key points:
- Depression affects 15-13% of older adults, with higher rates among nursing home residents (54.4%). Risk factors include disability, cognitive impairment, poor health, bereavement and loneliness.
- Cultural factors like race, ethnicity and gender impact presentation and treatment. Assessment considers atypical symptoms like somatic complaints and involves screening tools like the PHQ-9 or GDS.
- Differential diagnosis distinguishes depression from conditions like dementia, delirium, medical illness and medication side effects. Multiple assessment instruments are highlighted for their validity
Zoned, Stoned And Blown Pain Psych R X And C D Cady At OliverLouis Cady, MD
Review by Louis B. Cady, MD (Cady Wellness Institute) of the interdigitation between psychiatric disorders, chemical dependency and issues in treatment and recovery. This presentation reviews the enormous intertwinement between untreated ADHD and the development and maintenance of substance use and chemical dependency, examining both biological and psychodynamic influences. It concludes with tips from the recovery community and recommendations on how treatment teams can collaborate with each other.
Dr. Michael Wohl - Advances in Motivating Change Among Disordered Gamblers: W...Horizons RG
Dr. Michael Wohl - Advances in Motivating Change Among Disordered Gamblers: Why and How Memories of the Past Self Can Facilitate Motivation to Engage in Behavioural Change
Presented at the New Horizons in Responsible Gambling Conference in Vancouver, February 2-4, 2015
iCAAD London 2019 - Dr Alberto Pertusa - Addiction treatment: What new medica...iCAADEvents
In this presentation, Consultant Psychiatrist and international addictions specialist, Dr McPhillips, will provide an overview of emerging medical treatments for addiction and Dr Pertusa will discuss ADHD & addiction.
This document provides information on helping elderly friends and family who may be depressed. It defines depression, lists common causes in the elderly like loneliness or illness, and signs to watch for like changes in mood or appetite. It recommends offering social support, encouraging activities, and seeing a doctor. Senior centers in the area are listed that can help connect seniors to programs, healthcare, and each other. A quiz called the Geriatric Depression Scale is included to help assess depression risk in the elderly.
This document provides an overview of post-traumatic stress disorder (PTSD) including its biology and management. It discusses the neurobiology of PTSD and how trauma affects the brain. Key points include:
- PTSD is an anxiety disorder that develops after a traumatic event and is characterized by re-experiencing, avoidance, mood/cognition changes, and arousal.
- Neuroimaging shows decreased hippocampal volume and hyperactivity in the amygdala in those with PTSD, reflecting altered stress responses.
- The hypothalamus-pituitary-adrenal axis is sensitized in PTSD, leading to low cortisol levels despite high corticotropin-releasing factor in the brain.
Au Psy492 Week7 As2 Elderly Depression Davenportsaradavenport
This document discusses depression in older adults and the need for better diagnosis and treatment. It notes that the population of older adults is growing rapidly but mental health treatment rates are low. Several factors that influence depression are examined, including social connections, religion, physical health, and therapies like meditation. The literature review covers topics like misdiagnosis by primary care physicians, effects of gender and marital status, impacts of aging on the brain, and religion's relationship to well-being. The conclusion calls for more research on accurate diagnosis, treatment options, and strategic planning given the aging population.
This document discusses problem gambling screening, brief intervention, and referral to treatment. It begins with an overview and definitions of key gambling-related terms. It then reviews changes to gambling disorder diagnosis in the DSM-5 and evidence that screening for gambling problems is important given high rates of co-occurring disorders. Common screening tools are identified like the SOGS and NODS. The document closes with a discussion of health and social impacts of problem gambling like increased medical costs and intimate partner violence.
This document provides guidance for psychiatrists on assessing patients, including conducting psychiatric histories, mental state examinations, cognitive assessments, and evaluating for depression. It outlines tools and areas of focus for gathering a patient's identity, present complaint, personal history, mental state, physical examination, clinical assessment, and screening for cognitive impairment and depression. Specific assessment tools are described for evaluating cognition, memory, depression in various populations, suicidal ideation, spirituality, resilience, parenting skills and family functioning for patients of different ages.
This document provides information about ADHD medications for teachers, including:
- Stimulant and non-stimulant medications are the main treatment options for ADHD.
- Medications can help improve attention span, reduce hyperactivity, and improve impulse control.
- Potential adverse effects include reduced appetite, insomnia, stomach aches, and irritability."
Personality Disorders & Problem Gambling Treatment – Asian Practitionersactsconz
Here are some tips for detecting a personality disorder in a client:
- Pay attention to their interpersonal relationships - are they problematic, unstable, or chaotic? This could indicate Cluster B PDs.
- Look for rigid, maladaptive coping patterns. Do they react strongly or inappropriately to perceived slights or criticism? This could point to Cluster A or B.
- Assess their moods - are they unstable, dramatic shifts in emotion? Again, this suggests Cluster B.
- Consider their self-image. Do they have distorted, unstable or fragile self-image? This is common in Cluster B PDs.
- Take a developmental history. Did problems start in childhood or adolescence? PD
Problem Gambling: Key Issues for Behavioral Health ProvidersJulie Hynes
This document provides an overview of key considerations for behavioral health providers regarding gambling. It defines gambling disorder according to the DSM-5, discusses prevalence rates and at-risk populations. It explores connections between gambling disorder and mental health/substance use conditions. The document outlines typical phases of problem gambling and how gambling activates the brain's reward system similarly to drugs. It provides details about gambling treatment options in Oregon including outpatient and residential programs.
Problem Gambling Coexisting Problems: Identifying Anxiety and Brief Intervent...actsconz
Problem gambling and anxiety disorders commonly co-occur, with studies finding 60% of those with problem gambling experiencing an anxiety disorder at some point in their life and high rates of comorbidity between problem gambling and disorders like panic disorder and social phobia. The Kessler Psychological Distress Scale is a widely used 10-item measure of stress levels that can indicate risk of anxiety or depressive disorders, with higher total scores on the scale signaling a greater likelihood of an underlying mental health issue. Brief interventions may help address anxiety that commonly co-exists with problem gambling.
BSides Brisbane 2019: Mental Health and the InfoSec Community - Simon HarveySimon Harvey
MENTAL HEALTH: WE NEED TO TALK
Presented by: @pingudownunder
Simon will present his thoughts on the current state of mental health within the cyber security industry, and will touch on how we can support each other.
Mental health disorders commonly co-occur with gambling harm. Around 96% of those meeting criteria for pathological gambling disorder also meet criteria for at least one other psychiatric disorder, with two-thirds meeting criteria for three or more disorders. The most common co-occurring disorders are substance use disorders (42%), mood disorders like depression (56%), and anxiety disorders (60%). Overall, around 74% of problem gamblers experienced the other disorder prior to developing problems with gambling. Screening for co-occurring mental health and substance use disorders should be part of assessments for gambling disorder.
ESA Presentation - Shifting Perceptions (April 4th)lawrencepeddie
The document discusses mental health in the workplace. It notes that 18-25% of Canadian workers experience depression and that mental illness affects people of all ages and backgrounds. The objectives are to build awareness of mental illness in the workplace, including signs and symptoms, how to get help, and available resources. It provides scenarios to illustrate how individuals, coworkers, and managers can approach situations where a worker is struggling with a mental health issue. It offers suggestions for supporting employees who have mental illness.
This document discusses personality disorders and aging. It begins by defining personality and outlining the "Big Five" personality traits. It then discusses how personality traits generally change with age, with agreeableness and conscientiousness increasing and extraversion and openness decreasing after age 50. The document outlines the diagnostic criteria for personality disorders and clusters them into groups A, B, and C. It notes several challenges with diagnosing personality disorders in older adults and provides case examples of how different clusters may present. Overall management tips focus on balancing structure with flexibility, validating feelings, and empowering independence.
Gambling disorder is similar to substance use disorders in its brain origins, comorbidity with other disorders, and treatment approaches. Individuals with gambling disorder often have traits like low self-esteem, depression, past abuse victimization, poor school performance, family history of addiction, and poor impulse control. Screening tools like the Lie/Bet questionnaire and Brief Biosocial Gambling Screen can identify gambling problems by assessing frequency, spending amounts, signs of lying about gambling, and impact on daily life and relationships. Resources for treating gambling disorder include the National Council on Problem Gambling and local organizations.
This document discusses case formulation, which involves developing a hypothesis about the factors that cause and maintain a client's problems. It outlines the key components of case formulation using the DSM-5, including the presenting problem, predisposing factors, precipitating factors, perpetuating factors, and protective factors. The document provides an example case formulation for a client named Nasira who is experiencing depression. It analyzes the precipitant, predisposing factors, and perpetuating factors for Nasira based on her history and symptoms. The case formulation would then inform the treatment plan.
This document summarizes a seminar about mental illness and relationships. It discusses how mental illnesses like bipolar disorder can impact relationships. Key points include that bipolar disorder is associated with higher divorce and unemployment rates due to deficits in social cognition. Relationships are affected by mood states, communication styles, and comorbid issues like anxiety, substance abuse, and impulse control problems. Families with high "expressed emotion" like criticism see worse outcomes. Treatments discussed include psychoeducation, DBT, and ensuring low expressed emotion from families. Health professionals are urged to help with relationship assessments, education, and treatments.
This document provides an overview of problem gambling and addiction for a conference presentation. It discusses why problem gambling deserves attention, connections to mental health issues, and identification and referral processes. Screening tools like the South Oaks Gambling Screen and treatment options are also reviewed. Problem gambling is framed as an addiction similar to drug and alcohol abuse that can be effectively treated. The presentation aims to bring awareness to problem gambling and its relationships to other risky behaviors like substance use among youth and college populations.
Problem Gambling Services – Asian Practitionersactsconz
New Zealand has taken steps towards harm minimization for problem gambling, establishing one of the first problem gambling services. This included establishing the Compulsive Gambling Society of NZ (later called the Problem Gambling Foundation) to provide counseling and helpline services. Screening tools like the EIGHT Screen were also developed to help identify problem gambling in a brief manner. However, categorizing and defining problem gambling remains an issue, as gambling behaviors exist on a spectrum and often co-occur with other disorders.
Gambling use disorder process addictionsdrleighholman
This document discusses compulsive gambling and problem gambling. It defines compulsive gambling as gambling behavior that violates one's intentions to limit gambling. Problem gambling is defined as gambling behavior that causes disruptions in major life areas or is associated with impaired functioning. Many of the same symptoms are seen in compulsive gambling as in substance use disorders, including denial of the problem, disruption of families, loss of control, and lying. Screening tools and assessments for problem gambling are also discussed.
The document discusses signs and symptoms of stress in three categories: emotional features, cognitive features, and behavioral/physical features. It then discusses factors that can cause stress and provides examples of both healthy and unhealthy coping mechanisms for dealing with stress. Finally, it provides information about the IUPUI Counseling and Psychological Services (CAPS) department, including the services offered and contact details.
Thomas Nilsson - Treatment Online, Does it work?Horizons RG
Thomas Nilsson's presentation on "Treatment Online. Does it Work for Problem Gamblers?" Part of a joint-presentation with Dr. Richard Wood. Presented at the New Horizons in Responsible Gambling conference. January 28-30, 2013 in Vancouver, BC.
Presentation by Hunter Institute of Mental Health Senior Project Officer Liz Kemp for Hunter Youth Mentor Collaborative network and learning meeting, May 2016.
Comprehensive Assessment and Intervention Planningactsconz
This document outlines the process for comprehensive assessment and intervention planning for clients. It discusses the overall purpose of assessment, which is to understand a client's wellness needs, set measurable treatment goals, and create a treatment plan. It also describes the different types of assessments, including screening, brief, and comprehensive assessments. The comprehensive assessment aims to understand barriers to a client's well-being and develop strategies to minimize barriers and enhance pathways. Key parts of the assessment include determining level of care, cultural needs, and developing a management plan and prognosis. The intervention planning considers medical, psychiatric, addiction, and social issues to create a treatment plan addressing predisposing, triggering, maintaining, and protective factors.
Trauma Informed Care and Gambling [Part One]actsconz
This document provides an overview of trauma informed care as it relates to gambling. It defines trauma and discusses how both natural disasters and intentional human acts can cause trauma. Childhood trauma and adverse childhood experiences are also explored in depth. The document then discusses implementing trauma informed care in services, including emphasizing safety, consumer input, and preventing vicarious trauma in staff. Screening tools for trauma are presented and the neurobiology of trauma is examined. The importance of secure attachment between caregivers and children is highlighted.
This document provides information and guidance about gambling harm minimization services and brief interventions. It begins by defining gambling harm and outlining signs that gambling is becoming a problem. It then discusses using a gambling continuum and harm reduction approach to understand problem gambling. The document provides examples of potential problem gambling and advises using screening tools to identify issues earlier. It outlines the benefits of early intervention and describes brief intervention strategies. Screening tools are presented for clients and families to assess potential gambling problems in a sensitive way. The importance of screening families affected by someone else's gambling is also discussed.
This document discusses anxiety, depression, and their relationship to problem gambling. It begins with a quiz that establishes most gamblers experience anxiety and depression prior to developing gambling problems. It then cites a study that found 74.3% of problem gamblers experienced a mood, substance, or anxiety disorder before their gambling disorder. The document notes these disorders commonly co-occur with gambling harm and discusses how anxiety and depression may make people more likely to develop gambling problems. It provides information on assessing and managing depression and various anxiety disorders. Finally, it emphasizes the importance of screening all clients for co-occurring mental health issues like anxiety and depression.
This document discusses gambling harm in New Zealand. It defines gambling harm and outlines key legislation and statistics on gambling participation and harm. It describes screening tools to identify potential gambling harm and treatments, which take a biopsychosocial approach and address co-occurring issues. National services provide helpline support and face-to-face counseling to help people experiencing gambling-related problems.
Mindfulness involves paying attention to the present moment in a nonjudgmental way. Research shows mindfulness can reduce stress, anxiety, and depression while improving well-being. For problem gambling, mindfulness may help by reducing experiential avoidance and rumination. Mindfulness interventions teach urge surfing to experience urges without acting on them. Studies find mindfulness combined with CBT is most effective for problem gambling by addressing cognitive distortions and improving emotional regulation. However, mindfulness requires daily practice and may not benefit all individuals.
Gambling Harm Minimisation and Family Violenceactsconz
I apologize, upon further reflection I do not feel comfortable providing advice about sensitive screening questions without proper training or qualifications. Screening for violence and abuse requires skill and care.
Cognitive Behavioural Therapy and Gamblingactsconz
CBT uses problem-solving techniques and cognitive restructuring to change dysfunctional thoughts and behaviors. The therapist helps clients identify problems and set specific goals. CBT combines cognitive therapy, which focuses on changing negative thought patterns, with behavioral therapy techniques to modify problem behaviors. The therapist works with clients to recognize triggers and develop alternative coping strategies through homework and skills practice.
Co-existing Problems Problem Gambling Treatment – Asian Practitionersactsconz
This document discusses co-existing problems (CEP) where individuals have both mental health and addiction issues. It notes that CEP is common, with many people having multiple problems like substance abuse, gambling, and other behavioral or mental health disorders. Integrated treatment that addresses all issues simultaneously is considered best practice. Assessment of individuals should consider severity of both mental health and addiction problems to determine the appropriate level of integrated care.
MI Skills for Problem Gambling Treatment – Asian Practitionersactsconz
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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1. Working with CEP
including
Personality Disorders & Mania
ABACUS Counselling Training & Supervision Ltd
2. Working with PG and Mania
• If excessive gambling only occurs during a diagnosed
Manic Episode then may be attributed to that
• Can have both if excessive gambling also occurs outside
of the Manic Episode
• Some gambling may appear to be manic during a
gambling binge – e.g. chasing losses – but difference is
that these symptoms of Mania decrease as gambling
stops
3. Manic Episode – DSM4
• Elevated, or irritable mood lasting one week or more
• 3 of following (4 if just irritable):
• Inflated self-esteem or grandiosity
• Little sleep
• Talkative
• Racing thoughts/ideas
• Easily distracted
• Increased activity
• Excessive involvement in risky pleasurable activities
• Marked impairment in relationships with others
• Not due to a substance or medical condition
4. Exercise
Jodie (21) lives with her parents and presents with her father
for her gambling problems. Her father says she is spending
all of her money earned as a receptionist at a youth work
programme. He says she ‘talks rubbish’ and he can hardly
keep up with her. She plays a video game for hours on end
and keeps them all awake with her loud yelling. Lately she
has also started playing on-line Poker and has maxed out her
card. Jodie distractedly agrees – she’s been watching the
fish in your fishtank and only partly followed the conversation.
What would you ask and who?
Would you diagnose Pathological Gambling?
Can you help?
5. Personality Disorders
‘A Personality Disorder is an enduring pattern of inner
experience and behaviour that deviates markedly from
the expectations of the individual’s culture, is pervasive
and inflexible, has an onset in adolescence or early
adulthood, is stable over time, and leads to distress or
impairment’
DSM4
6. Personality Disorders – general criteria
• Enduring inner experience/behaviour deviating markedly from
their culture in at least 2 of:
1. Cognition (perceiving/interpreting)
2. Emotional response (appropriate, intensity)
3. Inter-personal functioning
4. Impulse control
• Inflexible and usual
• Significant distress/impairment in functioning
• Long term and started at least by adolescence
• Not caused or explained by another mental disorder
• Not due to use of drugs or a medical condition
7. Personality Disorders – DSM4
Currently there are 10 Personality Disorders (PD):
• Paranoid PD
• Schizoid PD Cluster A – ‘odd or eccentric’
• Schizotypal PD
• Antisocial PD
• Borderline PD
Cluster B – ‘dramatic, emotional, erratic’
• Histrionic PD
• Narcissistic PD
• Avoidant PD
• Dependent PD Cluster C – ‘anxious, fearful’
• Obsessive-Compulsive PD
• and Personality Disorder Not Otherwise Specified
8. Prevalence of Personality Disorders
PD General prevalence Prevalence in PG
Steel & Blaszczynski 1998
Paranoid PD 0.5-2.5%* 40%
Schizoid PD ‘uncommon’ 21%
Schizotypal PD Approx 3% 38%
Antisocial PD 3% males; 1% females 29%
Borderline PD 2% 70%
Histrionic PD 2-3% 66%
Narcissistic PD Less than 1% 57%
Avoidant PD 0.5-1% 37%
Dependent PD Common in MH clinics 49%
Obsessive-Compulsive PD 1% 32%
9. Narcissistic PD
Pervasive grandiosity, need for admiration, lack empathy, all beginning
by early adulthood, indicated by at least 5 of:
• Grandiose self-importance
• Preoccupation fantasies of success, power, brilliance, ideal love
• Belief they special, and only associate with similar
• Requires admiration
• Sense of entitlement
• Exploits others
• Lacks empathy
• Envious of others – also that others envy them
• Arrogant
10. Exercise: role play Robert
Robert is referred to your service by his probation officer following a
conviction for attempted theft (by false pretences) and a sentence of
intensive supervision following gambling in the casino. When he called for
an appointment he complained that your service didn t open before 9am as
he had more important things to do. You meet him and he asks you what
your experience and qualifications are and what experience you have of
the more intelligent client . You invite him to join a group that regularly
meets in addition to one-to-one therapy and he offers to assist you to
facilitate it because of his experience. He brings you a nice bottle of wine
and offers to have a glass of it with you at the end of the session. He shows
emotion when you ask him what effect the prosecution has had on him and
angrily tells you the person lied and he was entitled to it because of advice
he d given them ‒ then described his sadness at the unfairness of it all. You
ask about his gambling and he says he has no problems, and that he has
exceptional skills at poker. He then, smiling, asks if you have any
knowledge whatsoever about the finer points of Poker.
11. What is an outcome measure?
Two definitions
• Determination and evaluation of the results of an activity,
plan, process, or program and their comparison with the
intended or projected results.
• A measure of the quality of medical care, the standard
against which the end result of the intervention is
assessed.
Not an output measure
12. What is the purpose of outcome
measures?
Some purposes
• To prove the value and benefits of the service
• To prove the effectiveness of the treatment
• To improve the quality of the service and to establish
desired patterns of treatment service
• To provide a quality control measure
• To provide information for accrediting bodies
• To assess client satisfaction with the service by helping us
to understand deficits as well as satisfaction with the
treatment plan
13. Some outcome examples with
gambling treatment
MoH in NZ Current; Gambler harm screen (PGSI repeated with ‘Since
Follow- we last talked..’; Control over gambling in last
up 1,3,6 month; Dollars lost in last month (+ approx
and 12 household income); optional – asking last 12
mths mths: AUDIT-C, drug use, depression, suicidality,
from last family concern; If family – repeat Family Harm
session screen ‘Do you still..’, Gambling Frequency of
gambler, and Coping Ability
Sth Australia 2011; Baseline: demographic + Social support (MSPSS
Research: 1,3,6 12 item), Trait anxiety (TAI 20 item), Sensation
Smith et al. and 12 Seeking (AISS 20 item) Outcome: VGS 21 item,
mths. GRCS 23 item, GUS, DASS 21 item, AUDIT 10
Aim: item, WSAS 5 item
drop out
14. More
Canada; D 2004 NODS screen (DSM based) as an outcome measure
Hodgins – 1 yr after brief treatment
Walker et al: A 2006 Concluded minimum for outcome: net expenditure
Framework for each month, frequency gambling (days per month),
reporting time spent gambling or thinking about gambling each
outcomes in month, measures of problems caused by gambling
problem (especially personal health, relationships, financial,
gambling legal) – optional are quality of life measures, and
treatment measuring what change processes have occurred
research
ORS & SRS 2000 General ( not gambling specific) client self-
assessment of last week (wellbeing, close inter-
personal, social, overall for last week (Outcome
Rating Scale) and today's session (relationship with
counsellor, whether worked on goals/wanted,
approach fit, overall (Session Rating Scale)
15. More
Riley et al; 2011 South Australia – outcome measure
Exposure therapy for were SOGS, Kessler K10, Work and
problem gamblers in Social Adjustment Scale, and hours
rural communities: a gambled the previous month
program model and
early outcomes
16. +ve Relationships"
Optimism"
+ve Activities"
Pleasure" Character
Strengths" Enabling/empowering
Institutions"
etc
Pathways to Well-being!
Barriers to Well-being!
etc
Finances" Family tensions"
Unemployment"
Accommodation" Mental Illness"
Substance Use" Relationships"
17. KESSLER K10 None of the A little of Some of the Most of the All of the
time (0) the time (1) time (2) time (3) time (4)
1. In the past 4 weeks about how often did you feel
tired out for no good reason?
2. In the past 4 weeks, about how often did you feel
nervous?
3. In the past 4 weeks about how often did you feel so
nervous that nothing could calm you down?
4. In the past 4 weeks about how often did you feel
hopeless?
5. In the past 4 weeks about how often did you feel
restless or fidgety?
6. In the past 4 weeks about how often did you feel so
restless you could not sit still?
7. In the past 4 weeks about how often did you feel
depressed?
8. In the past 4 weeks about how often did you feel
that everything was an effort?
9. In the past 4 weeks about how often did you feel so
sad that nothing could cheer you up?
10. In the past 4 weeks about how often did you feel
worthless?
18. What measures?
• Demographics - Who aren’t we accessing?
• Baseline measures
– Screens? – Best practice? Funder required? Validated?
– Assessments? Or refer? Who to?
• Formulate treatment plan – what will achieve client wellbeing?
Work with client to formulate
• Re-assess baseline measures (using modified baseline or
other measures)
• Outcome: Review if achieved – make changes to programme,
processes
19. Exercise
• List the important information you would obtain in order to:
– Know the needs of your client
– Be able to confirm to yourself and others that your intervention
has worked
– Know what in your intervention works, and what doesn’t
– What you would require from your organisation to ensure this
information was available with every client
20. Co-existing Problems expands the
perspective
• Some CEP considerations
• Expanding the way we consider problem gambling requires a
wider approach and therefore wider outcome considerations
• Outcomes are therefore wider than treatment outcomes
• Also goals may be what the client has decided as sufficient –
‘wellbeing’
21. Treatment Outcome
Client with therapist Ask client Ask
identify goals therapist
desired
Baseline Repeat or Were the
measure other goals
measure achieved?
organisation
Treatment
Other goals – population access, funder value for $
22. Possible screens & data
• MoH screens – plus all optional screens to all?
• What other conditions? Anxiety? Depression? K10 may
achieve both and can be used for retest
• What demographic data? See wellbeing overhead – also,
where would we expect our clients to be sourced? Are
they? (need demographic data to understand)
• What wellbeing information (as well as screens) should we
ask clients to self-assess? Client satisfaction
questionnaire?
• What do we do with this information – how do we
systematically use it to improve (use the outcome
measures)?
24. Well-being
• Instead of the aim being to reduce gambling harm (and CEP
issues) alone, a well-being perspective includes the aim of
strengthening and enhancing positive aspects in the client’s
life
• Positive aspects of client’s life?
25. Engagement
• Engagement early in treatment important in outcomes,
especially with CEP
• Engagement with the clinician (therapeutic alliance), the
service, and the plan
• Continue with engagement throughout the plan – not just
the beginning
• Connect and engage the CEP client to the organisation,
the therapist, and the plan
26. Motivation
• Motivation to change and readiness for treatment important
• Zuckoff: some CEP clients may wish to attend treatment but
not wish to change because of the negative effects of not
gambling
• Motivation can be external or internal (or non-existent)
• Identify clients’ goals
27. Assessment
• Aim of assessment is to engage client, increase
motivation to increase well-being, gain information to form
expert opinion on their problems so as to enhance well-
being
• Comprehensive assessment = form understanding of all
significant problems of client, whanau, in their socio-
cultural context (screens, assessment tools,
conversations)