Flo A. Stein, MPH
NC PIC Project Manager
Chief, Community Policy Management
Division of MH/DD/SAS

A message from Flo...

  • Events Calendar

    • Events are coming soon, stay tuned!
  • EBP Quick Links
    MH#1: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
    Mental Health Bulletin #1 - Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) was developed to treat post-traumatic stress and related emotional and behavioral problems in children and adolescents.
    MH#2: Integrated Dual Disorders Treatment (IDDT)
    Mental Health Bulletin #2 - Integrated Dual Disorders Treatment (IDDT) requires that mental health and substance abuse treatment be delivered concurrently by a team of cross-trained clinicians within the same program.
    MH#3: Wellness Management and Recovery (WMR)
    Mental Health Bulletin #3 - The National Institute of Mental Health estimates that approximately 6% of the U.S. population has severe mental illness (SMI). For North Carolina, that percentage translates to approximately 200,000 people who suffer from severe psychiatric disorders.
    MH#4: Family Psychoeducation
    Mental Health Bulletin #4 - Persons with severe mental illness (SMI) often rely on family members for the majority of their needed support, and it is estimated that 35-60% of adults with SMI live with family members.
    SA#1: Contingency Management (CM)
    Substance Abuse Bulletin #1 - Contingency management (CM) is a motivational incentive intervention in which clients with substance use disorders receive small rewards for attending treatment, taking prescribed medication, providing negative urine samples, or complying with other defined treatment-related goals.
    SA#2: Strengthening Families Program (SFP)
    Substance Abuse Bulletin #2 - The Strengthening Families Program (SFP) is a parenting and family strengthening program for high risk families. It combines science-based (1) parenting-skill training, (2) child life-skill building, and (3) family lifeskill education into a program that improves the child's social/life skills and family functioning and protects the children from the long-term risks of drug abuse.
    SA#3: Seeking Safety
    Substance Abuse Bulletin #3 - Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that may result from exposure and sometimes multiple exposures to highly traumatic events such as child abuse, accidents, violent personal assaults, military combat, or natural or human caused disasters.
    SA#4: Matrix Intensive Outpatient Treatment
    Substance Abuse Bulletin #4 - Matrix was developed in the 1980s by researchers at the University of Southern California and clinicians at the Matrix Institute on Addictions who found that clients addicted to stimulants were challenging the existing treatment system.
    SA#5: The Seven Challenges
    Substance Abuse Bulletin #5 - The Seven Challenges program was developed in the early 1990s by Dr. Robert Schwebel who recognized the lack of age appropriate substance abuse treatment models for adolescents.
    Developing Effective, High-Quality Community Mental Health and Substance Abuse Services: A Guide for Local Management Entities
    by Beth Melcher, Ph.D. This manual seeks to clarify and provide guidance to LMEs on how to successfully engage in the service development role. It promotes the implementation of evidence-based and best practice services and supports.
    National Registry of Evidence-based Programs and Practices
    NREPP is a searchable database of interventions for the prevention and treatment of mental and substance use disorders. SAMHSA has developed this resource to help people, agencies, and organizations implement programs and practices in their communities.

    PIC Application
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    Free Online Courses
    The Medical University of South Carolina (MUSC) offers free training and resources on a variety of topics, including cognitive processing therapy and trauma-focused cognitive based therapy (TF-CBT) (http://tfcbt.musc.edu/). Developed by Patricia Resick, Ph.D., in 1991, Cognitive Processing Therapy (CPT) is a manualized cognitive based therapy offered in 12 sessions. Clients complete worksheets and homework assignments to gain further understanding and insight about past traumatic events. In addition to the MUSC website, more detail about CPT can be found here. Developed in the early 1980s by Cohen, Deblinger, and associates, TF-CBT is a psychosocial treatment model designed to treat posttraumatic stress and related emotional and behavioral problems in children and adolescents. The treatment model is designed to be delivered by trained therapists in 12-16 sessions of individual and parent-child therapy. Click here for more information.


    November 17th, 2011
    NC PIC Meeting, November 9, 2011 Wrap-up

    The working relationship between the NC Department of Corrections and the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SA) has been growing in strength and meaning for many years.  While the importance of this working relationship was promoted by Flo Stein, Chief, Community Policy Management, DMH/DD/SAS, it has become a promising reality thanks to the efforts of team leader Sonya Brown and her justice systems innovations team.  There is an obvious relationship between state correctional systems and public healthcare systems. In every State across the U.S., inmates are released from prison into a given community.  Despite this inevitable daily event, links between correctional systems and community behavioral health service systems are often poorly established or ignored altogether.  The importance of these relationships has not been ignored by crucial leaders from the two agencies, Steve Jordan and Tracy Little.  Moreover, the strengths of these working relationships were further realized last week as key stakeholders from the NC PIC, the Division, and NCDOC met to discuss evidence-based practices in correctional settings and current legislation that promotes positive transitions from one setting to another while simultaneously working to reduce recidivism.

    The meeting started with Ms. Brown introducing the most recognized researcher in correctional psychological science in the world, Dr. Paul Gendreau.  Dr. Gendreau opened with a comprehensive review of the history of treatment and treatment philosophies in correctional settings. He followed this review with a detailed look at the benchmark studies that have shaped the discipline and the evidence we have to date on “what works and doesn’t work”.   He closed with recommendations for the future and addressed questions from NC PIC members and guests.  The two key recommendations that Dr. Gendreau proposed is that systems must be committed to employing evidence-based practices and  that systems must stop using rehabilitation models that do not work.

    Steve Jordan, Director of DMH/DD/SAS opened the afternoon session with a discussion on Justice Reinvestment and the importance of continued emphasis on what works in communities across NC.  He introduced Representative David Guice who discussed a legislative act he championed, the Justice Reinvestment Act.  Of note,  Representative Guice was elected to the NC House of Representative in 2008 after a 30-year career in corrections. The Deputy Secretary of NCDOC, Tracy Little, followed Rep. Guice’s general review of HB642 with a detailed assessment of the implications of this new legislation and how it will impact specific domains within the system.

    Speaker Presentations

    Paul Gendreau, OC, PhD

      Effective Correctional Treatment: History, Evidence, Implementation (1.7 MiB)

    Rep. David Guice and Tracy Little

      Justice Reinvestment: What it means for North Carolina (176.0 KiB)

    Meeting Agenda

      November 9, 2011 NC PIC Meeting Agenda (139.0 KiB)

    Posted in PIC News & Updates
    October 26th, 2011
    RSVP for November 9, 2011 NC PIC Meeting

    RSVP for the November PIC Meeting

    Posted in PIC News & Updates
    September 29th, 2011
    NC PIC Meeting, September 19, 2011 Wrap-up

    Thank you to all of the NC PIC members and friends of the NC PIC that were able to join us for our September 19, 2011 NC PIC Meeting that featured 4 exceptional speakers.  Copies of the meeting agenda and the speaker presentations are available below.  Minutes for the afternoon meetings will be posted soon.

    Speaker Presentations:

    Dr. Terri Shelton, a PIC member herself, reviewed the criteria associated with practices identified as evidence based and she reviewed the resources available to NC providers seeking to learn and offer evidence based techniques to the children they work with.

      Evidence-Based Practice and Practice-Based Evidence: Working the Best we Can with Children/Adolescents and their Families – Presentation by Terri Shelton, PhD (958.0 KiB)

    Charla Suggs presented on the innovative criminal justice model, Thinking for Change.  This is a Cognitive Behavioral Intervention that guides participants toward the change process using cognitive restructuring and reframing.

      Thinking for a Change: An Integrated Congnitive-Behavioral Intervention Curriculum – Presentation by Charla Suggs (5.9 MiB)

    Dr. Claire Collie presented on Evidence Based Practices that are recognized by the VA.  EBPs of note included Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) for PTSD and Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (ACT) for Depression.

      Evidence Based Psychotherapies in the VA – Presentation by Claire Collie, PhD (84.2 KiB)

    Dr. Nancy Razza presented on the specific needs and problems that people with mental health problems and intellectual disabilities face.  Included is an excellent field study that examined the trials and tribulations of more than 4,000 persons born between 1959 and 1965 at intervals of 1,3,4,7,8, and 30 years.

      Trauma, Mental Health, & Intellectual Disability – Presentation by Nancy Razza, PhD (3.2 MiB)

    During the afternoon session of the DD NC PIC meeting, Dr. Nancy Razza examined the relationship between Trauma and Limbic Regulation as this relates to psychotherapy and the treatment of abused populations.

      Limbic Regulation, Trauma, & Psychotherapy – Presentation by Nancy Razza, PhD (231.5 KiB)

    Meeting Agenda:

      September 19, 2011 NC PIC Meeting Agenda (139.0 KiB)

    Posted in PIC News & Updates
    May 23rd, 2011
    May 19, 2011 NC PIC Meeting Wrap-up

    For all of you that attended last week’s NC PIC meeting, thank you for your attendance and active participation.  Those of you who could not make it were missed and I look forward to seeing you next time.  Attached below is the presentation on the Implementation of Evidence Based Practices presented by Dean Fixsen.

      Implementation, Organization Change, and System Reinvention (761.8 KiB)

    Posted in PIC News & Updates
    January 10th, 2011
    Guided by Science, Grounded In Practice

    Posted in PIC News & Updates
    November 30th, 2010
    2011 NC PIC Congress

    Members from all levels of state government, a key official from SAMHSA, clinicians and LMEs across North Carolina, and members of the NCPIC convened for our NCPIC Congress on November 10 2010 to review our progress to date and to discuss the future direction of NCPIC. The minutes to this Congress are available here:

      2010 NC PIC Congress Meeting Minutes (74.5 KiB)

      Behavioral Health 2010 - Eric Broderick, D.D.S (1,024.0 KiB)

      The Affordable Care Act - Marty Ford (2.4 MiB)

    Posted in PIC Events, PIC News & Updates
    September 22nd, 2010
    Health Reform Document released at the Summit

    We released Addiction Recovery Peer Service Roles: Recovery Management in Health Reform at the Summit, building on the comments and thoughts developed at the July 1, 2010 Recovery Roundtable co-sponsored with ONDCP. Thanks to everyone who contributed to this important document. We are using it to weigh in with federal agencies during the implementation of health reform. Please use this information during state-level health reform discussions.

    Posted in PIC News & Updates
    August 6th, 2010
    HHS Strategic Plan: Submit Your Comments

    The draft HHS Strategic Plan for Fiscal Years 2010–2015 was recently posted on the U.S. Department of Health and Human Services (HHS) Open Government Web site. The Open Government site allows the public consultation process truly to be participatory. Individuals can review and comment on the draft plan as well as see the comments posted by others.

    To ensure the broadest possible participation in the development of the Strategic Plan, please review and comment on the draft. The public comment period will end August 14, 2010.
    Comment Now

    Posted in PIC News & Updates
    June 7th, 2010
    MH4: Family Psychoeducation

    Persons with severe mental illness (SMI) often rely on family members for the majority of their needed support, and it is estimated that 35-60% of adults with SMI live with family members. Research has shown that families need and want information and support from professionals about how to assist in their SMI family member’s recovery as well as how to cope with the problems and challenges that inevitably arise when working with SMI family members.

    The Family Psychoeducation model is designed to address these needs. It has been proven not only to be highly effective in promoting recovery, but is also cost effective.

      Family Psychoeducation (203.0 KiB)

    Posted in PIC News & Updates
    March 29th, 2010
    SAMHSA Science and Service Awards

    In 2007, SAMHSA created the Science and Service Awards as a national program to recognize community-based organizations and coalitions for exemplary implementation of evidence-based services. The deadline for applications is APRIL 9, 2010.

    Eligibility Criteria
    The organization and/or coalition implementing the evidence-based intervention should be able to demonstrate positive outcomes from the intervention in at least one of the five award categories. Both public sector (State, local, territorial, tribal) and private sector organizations and/or coalitions are eligible for a Science and Service Award.

    There are 5 categories that individuals can apply for. These categories are:

    1. Mental Health Promotion
    2. Treatment of Mental Illness and Recovery Support Services
    3. Substance Abuse Prevention
    4. Treatment of Substance Abuse and Recovery Support Services
    5. Co-Occurring Disorders

    The link to the awards program is as follows:      http://www.samhsa.gov/scienceandservice/

    Posted in PIC News & Updates
    February 12th, 2010
    Differences in MI & MET Explained

    mi_3of3Motivational Interviewing (MI) is a therapeutic style that addresses client ambivalence and enhances motivation for positive change. MI is a particularly effective strategy for enhancing and maintaining client engagement in treatment.

    Motivational Enhancement Therapy (MET) is a specific application of MI developed by Dr. Miller for use in the treatment of substance use disorders. Numerous studies have shown that MET reduces the intensity of drinking behavior in a number of diverse populations.

      Differences in MI & MET Explained (97.5 KiB)

    See also:
    MI Release 1 of 3 - What is motivational interviewing?

    MI Release 2 of 3 -Why is MI so important?

    

    Posted in PIC News & Updates
    January 28th, 2010
    Why is MI so important?

    mi_203Person-centered care is an effective way to help consumers with mental illness, substance abuse related disorders, and/or development disabilities meet their own personal goals.  A person-centered approach is associated with improvements in the lives of consumers. “Individualizing treatment services has been shown to improve outcomes” (Robert Drake, Ph.D., Dartmouth University as presented to the Committee on the Quality of Health Care in America, in Crossing the Quality Chasm, Institute of Medicine, 2001). In addition, consumers identify a person-centered approach as a critical component of their care. According to the President’s New Freedom Commission on Mental Health, “Nearly every consumer …expressed the need to fully participate in his or her plan for recovery.” (New Freedom Commission, 2003).

      WHY ARE MOTIVATIONAL INTERVENTIONS SO IMPORTANT? (129.4 KiB)

    See also:
    MI Release 1 of 3 - What is motivational interviewing?

    Posted in PIC News & Updates
    January 14th, 2010
    Addressing the Needs of Our Returning Veterans

    ncpic_returning_veterans_cover

    From the Battlefront to the Home Front and Back Again

    ritchie Col. Elspeth Cameron Ritchie, M.D., M.P.H., Adult and Forensic Psychiatrist and Director, Behavioral Health Proponency in the Office of the Army, The Surgeon General

      From the Battlefront to the Home Front and Back Again (1.3 MiB)

    Depression: An Illness You Can’t See

    Mrs. Carol Graham, wife of Major General Mark A. Graham, US Army, Deputy Chief of Staff, G-3/5/7, US Army Forces Command, Fort McPherson, Georgia and keynote faculty of the 2007 National Military Suicide Prevention Conference and the 2008 AUSA National Guard Suicide Prevention Conference

    Taking the Fight to the Enemy

    Storti Evidence-Based Substance Abuse Interventions for Iraq and Afghanistan Veterans
    Susan A. Storti, PhD, RN, CARN-AP, Project Director of the National Institute on Drug Abuse Blending Research and Practice and the former Director of the Addiction Technology Transfer Center of New England at Brown University’s Center for Alcohol and Addiction Studies.

      Taking the Fight to the Enemy (8.0 MiB)

    An Integrated Approach to Working with People with Traumatic Brain Injury

    ritchie Jim Hardiman MSW, LCSW, CSAC, Clinical Director at Virginia NeuroCare and the Regional Care Coordinator for the Defense and Veterans Brain Injury Center

      An Integrated Approach to Working with People with Traumatic Brain Injury (262.1 KiB)

    Posted in PIC News & Updates
    January 12th, 2010
    What is Motivational Interviewing?

    mi_1of3Motivational Counseling is a person-centered form of counseling and has its roots in the work of Carl Rogers in the late 1950s.  Referred to as the existential-humanistic tradition, the goal of this counseling philosophy is to help the client remove barriers that limit his/her ability to live a meaningful life. Rogers published Client-Centered Therapy in 1951 but continued to develop his theories, eventually referring to applications of his theories as “person-centered” approaches.

    Part 1 of a 3 part release.  The next release will cover “Why MI is important in delivering public services in North Carolina”

      WHAT IS MOTIVATIONAL INTERVIEWING? (191.2 KiB)

    Posted in PIC News & Updates
    October 8th, 2009
    SBIRT & WHAT

    Wilmington Health Access for Teens, Inc. (WHAT) began implementing SBIRT in August 2008 and the program continues to make progress. The pilot program has been funded by the Governor’s Institute of Alcohol and Substance Abuse and the NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services. SBIRT was presented to the NC PIC in February 2008.

      An SBIRT Success Story (64.5 KiB)

    For more information on Screening, Brief Intervention, Referral and Treatment (SBIRT) click here.

    Posted in PIC News & Updates
    September 1st, 2009
    Kana Enomoto Challenges North Carolina

    to Join SAMHSA in Promoting Trauma-Informed Care

    nc-pic-august-2009-3335On August 13, 2009, Kana Enomoto, Acting Deputy Administrator and Acting Associate Administrator for Women’s Services, Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services, presented the keynote address at the North Carolina Practice Improvement Collaborative meeting on Trauma.  Ms. Enomoto stated that the SAMHSA  Acting Administrator, Dr. Eric Broderick has stressed that trauma can affect any citizen at any time and can negatively impact  people’s mental and physical health, resulting in serious life consequences when left untreated.

    To address this critical issue, the federal agency supports the development of trauma-informed systems of care for every community.  To illustrate how a trauma-informed system would operate, Ms. Enomoto presented a fictitious case study of services in two cities.  She noted that the most effective outcomes for people are achieved when the operating principles for the services are trauma-focused, person-centered, and recovery-oriented.

    SAMHSA is committed to elevating the visibility of the issue and providing helpful tools for states and communities to promote recovery and healing for trauma survivors.  It is working hard to disseminate information about delivering trauma services and setting up demonstration projects that seek new ways to create trauma-informed systems.

    In the afternoon, the Acting Deputy Director spent time one-on-one with the members of the NCPIC Mental Health and Substance Abuse Subcommittees.  The members in attendance discussed with Ms. Enomoto their experiences with the implementation of evidence-based practices.

    Ms. Enomoto congratulated the members for being leaders that embrace and value evidence-based practices to improve consumer services.  She noted that North Carolina was indeed a national leader in working to advance the use of best practices and programs. She encouraged the NCPIC members to focus on the concept that the best research evidence is also backed by clinical expertise, patient value, and cultural considerations.  The NCPIC members were challenged and invigorated by the encouragement provided by Ms. Enomoto and look forward to new SAMHSA initiatives in this area.

      Trauma-Informed Care A Call to Action - Part 1 (400.2 KiB)

      Trauma-Informed Care A Call to Action - Part 2 (195.4 KiB)

    Posted in PIC Events, PIC News & Updates
    May 14th, 2009
    2009-2010 PIC Dates Announced – Save the Date

    The PIC dates for FY 2010 are as follows: August 13, 2009, November 12, 2009, January 14, 2010 and the Annual PIC Congress May 13, 2010. The format for the PIC meetings has changed with all three disability subcommittees meeting on each of the above dates. The morning session will host plenary speakers to the full group and during the afternoon the subcommittees will meet separately for disability specific presentations and discussion. Locations and speakers TBA.

    Posted in PIC News & Updates
    April 20th, 2009
    DD PIC Meeting

    Title: DD PIC Meeting
    Location: Center for Learning and Development – Chapel Hill
    Description: Dr. Marc Tasse, from the University of South Florida, will provide information about Resource Allocation. There will be time for questions and discussion on this important topic.
    Start Time: 10:00AM
    Date: 05-08-2009
    End Time: 2:00PM

    Posted in PIC News & Updates
    March 18th, 2009
    MH PIC Meeting

    Title: MH PIC Meeting
    Location: Monteith Research Center – NCSU
    Start Time: 11:00
    Date: 2009-05-29
    End Time: 15:00

    Meeting will include a presentation by Dr. Daniel Herman of Columbia University who will present on Critical Time Intervention, a program designed to prevent recurrent homelessness and other adverse outcomes among persons with severe mental illness. It aims to enhance continuity of care during the transition from institutional to community living.

    Posted in PIC News & Updates
    March 18th, 2009
    SA PIC Meeting

    Title: SA PIC Meeting
    Location: Monteith Research Center – NCSU
    Start Time: 10:00
    Date: 2009-05-01
    End Time: 14:00

    Meeting will include the following presentations:

    • Dr. Sherri Green, PI on Robeson County Bridges for Families Grant
    • Mr. Tom Savidge, CEO Port Human Services, presenting application for the PORT Adolescent Residential Treatment Model
    Posted in PIC News & Updates

    Funded wholly or in part by the federal Substance Abuse Prevention and Treatment Block Grant Fund (CFDA #93.959) as a project of the NC Division of Mental Health, Developmental Disabilities & Substance Abuse Services.