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Operationalizing Person-Centered Care

in SUD Treatment

With 8 Dimensions

Barbara “Basia” Andraka-Christou, JD, PhD

Assistant Professor, University of Central FloridaBarbara.andraka@ucf.eduwww.bandrakachristou.com

AcknowledgementsThriving Mind, dba South Florida Behavioral Health Network (community partner)

Health Foundation of South Florida (funder)

Team Members:• Danielle Atkins, PhD• Olena Mazurenko, MD, PhD• Olivia Randall-Kosich, MHA• Rachel Totaram, MHA• Andriy Koval, PhD• Kendall Cortelyou-Ward, PhD• Kyle Belanger, BS

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Objectives

1

Describe the importance of person-centered care (PCC)

in substance use disorder (SUD) treatment

3

Identify specific approaches for operationalizing each of

the 8 dimensions

2

Summarize the 8 dimensions of PCC

4

Discuss potential barriers & facilitators to

operationalization

Broadly speaking, person-centered care is about two things:

1) individualization and

2) holistic care

Consider the opposite of PCC…

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● Our team wanted to identify HOW to do PCC

● Specifically in SUD treatment

● Across 8 dimensions

● Using perspectives of multiple types of stakeholders

● Obtained using a mixed method approach

Introduction

Qualitative Quantitative

1. Interviews with South Florida clients, clinicians, & administrators to identify different operationalization methods (n=38)

2. Create a survey to confirm importance of operationalization methods to clients (n=32)

3. Create a survey for staff to examine frequency of operationaization methods in South Florida corporations (n=61; j=6)

Our Approach

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Eight Dimensions

1Respect for preferences,

values, & culture

2Provision of information

3Integration of

care

5Physical comfort

6Integration of

family

4Emotional Support

7Transition out of care

8Access to

evidence-based treatment

Sample of operationalization

methods

There are many more

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Respect for client preferences, values, & culture

●Peer support groups○No attendance requirements○Choice in type (including non-12 step)○No overt Christian prayers

●Culture/diversity○Bilingual staff○Programming in other languages○Interpreter services○Staff diversity matches clients○Food/art from other cultures○LGBTQ programming

● Individualization of care○ Harm reduction goal option○ “Menu” of treatment options○ Recommend, don’t require○ Ask level of choice desired

● Counseling○ Group/individual not required ○ No precondition for meds○ Client choice in counselor

characteristics○ Can pick among counseling

topics○ Allow counselor changes if

desired● Can tour facility first

Provision of information●Multiple types of information

○Treatment process○Treatment purpose○How to file grievance○Treatments available, risks/benefits○Rights/responsibilities

●Methods○Verbal○Written○Visual○Public places○Group, one-on-one○Time for questions○Ask how client learns best

● Timing○ At the beginning○ Throughout

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Integration of care

●Comprehensive health assessments○Psychiatric/mental○Physical○SUDs○Family history○Dental○OBGYN○Communicable diseases

●Comprehensive treatment○Psychiatric/mental○Physical○SUDs○Family history○Dental○OBGYN○Communicable diseases

● Connecting to outside providers● Schedule appointments● Transportation help● Attend with the client● Regularly share info with

outside providers● Written/electronic medical

record provided to client● Interfacility staff communication

○ Variety of professional roles add notes to medical record

○ Variety of professional roles attend case conferences

● Staff attends court hearings/celebrates milestones

Emotional support

●Peer support specialists available●Staff includes people with lived experience●Empathy/compassion demonstrated by all staff (including front desk)●Animal therapy, pets permitted●Counseling as often as needed●Evaluated and treated for trauma●Can turn to someone on staff 24/7●Holistic health opportunities (e.g., yoga, meditation)

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Physical comfort

●All facilities:○Clean facility○Home-like facility (not like a prison/hospital)○Attractive facility○Natural lighting○Interesting artwork

●Medication available if needed●Provide necessities●Safety measures (guards, alarms)

●Residential:○Bedrooms

■Roommates optional■Couples can room together■Private lockers■Comfortable ■Staff knock■Can sleep in

○Food/beverages■Access 24/7■Can cook for self, get groceries■Nutritious and tasty■Choice in food■Respectful of different diets

○Recreation■Exercise, garden■TV, games

Family integration

●Communication (residential)○Unlimited phone calls (minutes, times of day)○Can go home for the weekend○Family can visit any time○Family events

●Family treatment/education○SUD/MHD education offered○Family coaching○Family therapy○Individual counseling for family members○Family members involvement level determined by client○Family attend treatment planning○Space for family to meet

●Parents with minors○Can room with parent (residential) ○Daycare ○Parenting classes○Staff helps navigate child welfare system requirements○Pregnant women welcome○Offer childcare supplies (e.g., diapers)

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Transition out of care

●Housing○Help with applications for housing and payment○Transitional housing available○Help with furniture○Visit housing with client

●Education/employment○Help with applications ○Can use computers on site for searches○Job fair on site○Job training opportunities on site○ESL, GED, other classes on site

●Aftercare ○Frequent check-ins post-discharge○Can continue seeing same counselor○Can come back if needed○Immediate connection to outpatient treatment

Access to evidence-based treatment

●Medications for behavioral health○For opioid use disorder ○For alcohol use disorder○For tobacco use disorder○For psychiatric disorder

●Individual counseling using EBT●Group counseling using EBT●Contingency management ●Withdrawal management●Integrated, multiple levels of care●Staff appropriately trained

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Next Steps

Step 1 Step 2 Step 3 Step 4

Confirm client preferences in

statewide sample

Examine barriers/facilitators to

implementation

Revise & validate staff survey

Implement staff survey in multistate

sample

Barriers? Facilitators?● Funding

● Culture

● Training

● State policy

● Institutional oversight, policy implementation

NOTE:

In our staff survey, we found inconsistencies in reporting of methods by administrators versus clinicians

Can you think of others?

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Resources● Davis, E. L., Kelly, P. J., Deane, F. P., Baker, A. L., 

Buckingham, M., Degan, T., & Adams, S. (2020). The relationship between patient‐centered care and outcomes in specialist drug and alcohol treatment: A systematic literature review. Subst Abus, 41(2), 216‐231. https://doi.org/10.1080/08897077.2019.1671940

● Gerteis, M. (1993). What patients really want. Health Management Quarterly, 15(3), 2‐6. 

● Gerteis M, E.‐L. S., Daley J, Delbanco TL. (1993). Through the patient's eyes: understanding and promoting person‐centered care. John Wiley & Sons, Ltd. 

● Marchand, K., Beaumont, S., Westfall, J., MacDonald, S., Harrison, S., Marsh, D. C., Schechter, M. T., & Oviedo‐Joekes, E. (2019, Sep 11). Conceptualizing patient‐centered care for substance use disorder treatment: findings from a systematic scoping review. Substance Abuse Treatment Prevention & Policy, 14(1), 37. https://doi.org/10.1186/s13011‐019‐0227‐0

● National Institute of Medicine. (2001). Crossing the Quality Chasm. https://doi.org/10.17226/10027

● Substance Abuse and Mental Health Services Administration. (2018). Medications for Opioid Use Disorder. Treatment Improvement Protocol (TIP) Series 63, Full Document. https://store.samhsa.gov/product/TIP‐63‐Medications‐for‐Opioid‐Use‐Disorder‐Full‐Document/PEP20‐02‐01‐006

Learn more about our study:

Email the project: pcc@ucf.eduEmail the PI: Barbara.andraka@ucf.edu

https://ccie.ucf.edu/person-centered-care/

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