Tonights panel Dr Paul Grinzi Lee Brient Monica Lord Dr Shalini - - PDF document

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Tonights panel Dr Paul Grinzi Lee Brient Monica Lord Dr Shalini - - PDF document

Oct 03, 2022 248 likes •397 views

Webinar DATE: Collaborating to recognise and address November 12, 2008 depression in cannabis users Wednesday 17 July 2019 Supported by The Royal Australian College of General Practitioners, the Australian Psychological Society, the

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Supported by The Royal Australian College of General Practitioners, the Australian Psychological Society, the Australian College of Mental Health Nurses and The Royal Australian and New Zealand College of Psychiatrists

DATE:

November 12, 2008 Webinar Wednesday 17 July 2019

Collaborating to recognise and address depression in cannabis users

Lee Brient Psychologist, Tas Dr Paul Grinzi General Practitioner, Vic

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Tonight’s panel

Dr Shalini Arunogiri Psychiatrist, Vic

Like to read more about tonight’s panellists? Click the resources icon at the top right of your screen for panel bios and more!

Monica Lord Accredited Mental Health Social Worker, Qld

  • Prof. Stephen Trumble

General Practitioner, Vic

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Ground rules

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To ensure everyone has the opportunity to gain the most from this live event please:

  • Be respectful of other participants and panellists: behave as you would in a

face-to-face activity.

  • Interact with each other via the chat box by clicking the icon at the top right
  • f your screen. As a courtesy to other participants and the panel, please

keep your comments on topic. Please note that if you post your technical issues in the participant chat box you may not be responded to.

  • Need help? Click the Help icon at the top right of your screen. If you still

require support, call the Redback Help Desk on 1800 291 863.

  • If there is a significant issue affecting all participants,

you will be alerted via an announcement.

Audio issues? Listen on your phone by dialling this phone number 1800 896 323 Passcode: 126 472 5328#

Learning outcomes

Through an exploration of depression in cannabis users, the webinar will provide participants with the opportunity to:

  • describe the factors associated with depression in cannabis users
  • identify the challenges, merits and opportunities in evidence-based

approaches deemed most effective in treating and supporting people experiencing depression from cannabis use

  • implement a referral pathway to support cannabis users with

depression.

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Click the Chat icon at the top right of your screen to chat with other participants.

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GP’s perspective

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Dr Paul Grinzi

GP’s perspective

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Dr Paul Grinzi

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GP’s perspective

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Dr Paul Grinzi

GP’s perspective

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Dr Paul Grinzi

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GP’s perspective

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Dr Paul Grinzi

GP’s perspective

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Dr Paul Grinzi

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Psychologist’s perspective

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Lee Brient

Expected referral pathway – GP referral to private psychologist through Mental Health Plan

  • Voluntary referral by self, GP or family member to a drug and alcohol

service

  • Police may mandate attendance as part of a caution process

Psychologist’s perspective

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Lee Brient

Comprehensive biopsychosocial assessment to determine the range of factors potentially contributing to Kyle’s presentation

  • Genetic and/or physical
  • Psychological
  • Social
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Psychologist’s perspective

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Lee Brient

Depression

  • Assess level of depression symptoms – DASS21: also provides

measures of anxiety and stress symptoms

  • Results guide indicated treatment efficacy
  • Interactions between mood and biopsychosocial factors

Psychologist’s perspective

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Lee Brient

Substance use

  • Assess level of use – cannabis and alcohol
  • Motivation to reduce/cease/abstain
  • Interactions between mood and biopsychosocial factors
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Psychologist’s perspective

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Lee Brient

Collaborative treatment plan likely to include

  • Psychoeducation to equip client with evidence-based info around his

issues

  • Cognitive strategies
  • Behavioural strategies
  • Motivational interviewing
  • Explore suitability of medication – possible recommendation of

referral to psychiatrist, in consultation with GP

Social worker’s perspective

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  • Home and environment
  • Education/Employment
  • Social
  • Relationships and sexuality
  • Drug and alcohol use (past and

present)

  • Mood/Depression symptoms
  • Stress/Anxiety symptoms
  • Appetite
  • Sleep
  • Risk – suicide, self-harm,

homicide

  • Mental health history
  • Psychosis symptoms
  • Other health conditions

Monica Lord

Assessment

Comprehensive biopsychosocial assessment

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Social worker’s perspective

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Monica Lord

Assessment of cannabis use and substance use more broadly

Social worker’s perspective

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Monica Lord

Assessing needs and determining motivation to change

  • What does the client want to achieve? What are their priorities?
  • Does the client have any long-term goals/plans?
  • How does substance use fit in with any long-term plans?
  • Assess motivation to change using ‘Stages of Change’ model
  • Working with resistance to change behaviours
  • Accepting and validating pre-contemplative motivation and working
  • n other goals to create a sense of achievement
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Social worker’s perspective

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Monica Lord

Intervention - An Accredited Mental Health Social Worker approach

Address low mood (CBT, MI, DBT, ACT)

  • Addressing cognitive distortions/automatic negative thoughts
  • “I’m so useless,” “I’m a failure,” “I don’t know what I want to do with my

life”

  • Goal setting (work, study, social, independence, intimate relationships)
  • Activity scheduling
  • Sensory modulation to regulate mood
  • Relaxation strategies (and address underlying anxiety symptoms if evident)
  • Sleep hygiene

Social worker’s perspective

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Monica Lord

Intervention - An Accredited Mental Health Social Worker approach

Address substance use (CBT, MI)

FIRST:

  • Address underlying causes for substance use (depression, anxiety, trauma . . . )

THEN:

  • Psychoeducation re: substance use; harm minimisation; options for the future if not

wanting to address use now

  • If wanting to quit now - Develop a comprehensive written plan for cutting down

/quitting – i.e. high-risk situations, managing urges and cravings, managing withdrawals

  • Assess concurrent substance use – alcohol, nicotine – do these require intervention

(e.g. Nicotine Replacement Therapy, additional quitting plan for nicotine)?

  • Address and plan for lapses/relapses
  • Family support – psychoeducation about substance use and mental health,

strategies to improve communication, strategies to support young person

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Psychiatrist’s perspective

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Diagnostic Assessment

  • Kyle’s identified concerns;

his treating professionals (GP, psychologist etc.) and his parents identify as their concerns and needs

  • How does Kyle’s mental

health and his function relate to and interact with his cannabis use

  • Rating scales e.g. depression

and anxiety instruments, sleep, mood, exercise and cannabis use diaries

Dr Shalini Arunogiri

National Comorbidity Guidelines

Psychiatrist’s perspective

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Dr Shalini Arunogiri

Any cannabis use 'Heavy’ cannabis use

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Psychiatrist’s perspective

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Formulation

  • Systems perspective and relationship dynamics
  • How does Kyle fit into his (i) family, (ii) his peer group, (iii) his community
  • What are the dynamics between Kyle and his parents, and/or Kyle and

his treating team, and how does this impact on his recovery?

  • Tying things together in a way that makes sense for Kyle – why are

things the way they are for him right now?

  • Kyle’s low sense of self-efficacy;
  • disempowerment in current situation;
  • social isolation and disengagement from peer group etc.

Dr Shalini Arunogiri

Psychiatrist’s perspective

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Risk Assessment

  • Informed by GP, other treating professionals, parents and Kyle
  • Mental health risks incl. psychosis
  • Risks to self/other
  • Risks relating to driving and motor impairment
  • Risks in terms of deterioration/recovery

Dr Shalini Arunogiri

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Psychiatrist’s perspective

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Recovery Plan

  • Recovery – needs, social recovery, self-efficacy, identified goals
  • The role of medication
  • Are they necessary? What is Kyle’s choice?
  • Weighing up risk/benefits of medication
  • Antidepressant choice
  • Guided by symptom profile
  • Support and education for family
  • Potentially seeing Kyle with family if this is his choice as this can support

Kyle, dispel some myths the family might have, and get everyone on the same page re: shared goals

Dr Shalini Arunogiri

Lee Brient Psychologist, Tas Dr Paul Grinzi General Practitioner, Vic

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Q&A session

Dr Shalini Arunogiri Psychiatrist, Vic Monica Lord Accredited Mental Health Social Worker, Qld

Facilitator:

  • Prof. Stephen Trumble

General Practitioner, Vic Audience tip: Click the ‘Ask a question’ icon at the top right of your screen to post a question to the panel.

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14 Don’t forget to complete the feedback survey Click the survey icon at the top right of your screen to open the survey.

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Thank you!