Curriculum

TRAINING OBJECTIVES:

The Addiction Psychiatry Fellowship Program at the University of Illinois Chicago has been developed to provide a solid foundation in evaluation, consultation, and treatment of:

1. Patients with substance-related disorders and their significant others seen in a variety of clinical settings as described above.
2. Medical and surgical patients in the emergency department, intensive care units, and general wards of the hospital setting with acute and chronic substance-related disorders, including also acute intoxication and overdose. 
3. Patients with substance-related disorders who also have comorbid  psychopathologies, as well as patients with medical comorbidities and particularly medical comorbidities commonly associated with substance-related disorders such as chronic pain, the hepatitides, and HIV-related disorders.

The Addiction Fellow will gain experience in dealing with substance-related disorders related to the following substances and groups of substances in a variety of settings:

1. Alcohol
2. Opioids
3. Cocaine and other stimulants
4. Marijuana and hallucinogens
5. Benzodiazepines or other sedative/hypnotics
6. Phencyclidine, ketamine or other dissociatives
7. Nicotine
8. Organic solvents
9. “Designer” and “club” drugs
10. Various over-the-counter substances of potential abuse

KNOWLEDGE BASE:

1. Knowledge of the signs and symptoms of the use and misuse of the major categories (and combinations of the major categories) of substances of abuse as well as knowledge of the types of treatment required for each category where there are differences in treatment approach
2. Knowledge of the signs of withdrawal from these major categories (and combinations of major categories) of substances and knowledge and experience with the range of options for treatment of the withdrawal syndromes and the complications commonly associated with such withdrawal syndromes
3. Knowledge of the signs and symptoms of overdose, the medical and psychiatric sequelae of overdose, and experience in providing proper treatment of overdose
4. Knowledge of the signs and symptoms of the social and psychological problems as well as the medical and psychiatric disorders that often accompany the chronic use and misuse of the major categories (and combinations of the major categories) of substances of abuse
5. Knowledge and understanding of the special problems of the pregnant substance user and of the babies born to substance-using mothers
6. Knowledge of significant other systems and significant other dynamics relevant to the etiology, diagnosis and treatment of substance-related disorders 
7. Knowledge of the neurochemical and structural bases, genetic vulnerabilities, risk and protective factors, epidemiology, and prevention of substance-related disorders
8. Understanding of the current economic, for example “managed care”, aspects of providing substance-related disorder, other psychiatric and other health-care services to patients with substance-related disorders
9. Knowledge of quality assurance issues pertaining to the treatment of patients with substance-related disorders
10. Knowledge of the cost effectiveness of various treatment modalities for patients with substance-related disorders

BASIC SKILL BASE:

1. Management of intoxication, detoxification and other acute treatments of the use and misuse of the major categories (and combinations of major categories) of substances of abuse.  This includes experience in working collaboratively with mental health professionals and other medical personnel in the emergency department, intensive care units and general and psychiatric hospital units in the diagnosis and management of acute problems related to substance-related disorders
2. Experience in the use of psychoactive medications in the treatment of psychiatric disorders often accompanying the major categories (and combinations of major categories) of substance-related disorders 
3. Experience in the use of techniques required for intervention with a patient with a substance-related disorder. This includes particularly dealing with the defense mechanisms that cause the patient to resist entry into treatment and other changes that need to be made to sustain a good recovery. Related to this, the Fellow will be familiar with the Stages of Change model as applied to addictions and the related motivational techniques
4. Experience in the use of the various psychotherapeutic modalities involved in the ongoing management of the patient with a substance-related disorders, including individual psychotherapies, couples and family therapies, and group therapies
5. Experience in working collaboratively with other mental health providers and allied health professionals, including nurses, social workers, psychologists, nurse practitioners, counselors, pharmacists, and others who participate in the care of the patient with a substance-related disorder

RESEARCH SKILLS:

1. Familiarity with major medical journals and professional-scientific organizations dealing with research around substance-related disorders
2. Critical analysis of research reports, as presented in journal clubs and seminars
3. See below under “Research Opportunities”.

TEACHING & SUPERVISION SKILLS:

1. Experience in teaching and supervising student clinicians at various levels in the care of patients with substance-related disorders
2. See below item #3 under “Didactic Opportunities”.

ATTITUDINAL BASE:

1. Acquire professional and ethical attitudes towards individuals with substance-related disorders and to recognize beliefs or counter-transference that may impede the ability to identify and manage patients with substance-related disorders
2. Acquire mature and compassionate attitudes and empathic and objective clinical judgment towards patients with substance-related disorders
3. Recognize that patients with substance-related disorders are diverse in many ways and that stereotypes interfere with recognition and treatment of these disorders
4. Consider substance-related disorders in the same context as other psychiatric and medical disorders-- that substance-related disorders are primary/independent disorders with lives of their own and also interactive with other disorders
5. Appreciate that substance-related disorders are treatable disorders that respond to specific modalities of treatment
6. Acquire the ability to interact with other professionals in order to establish clinical approaches for patients with substance-related disorders comorbid with disorders including psychiatric, medical, and surgical disorders
7. Acquire the sensitivity to treat a variety of patients with substance-related disorders, including women, the elderly, adolescents, the developmentally disabled, and minorities
8. Acquire an objective approach and an intuitive attitude based on sound clinical experience and data provided by research studies
9. Acquire the ability to utilize resources for the short and long term management of substance-related disorders in the community