Curriculum standards

Knowledge guides

LG 15: Psychological and pharmacological approaches to treatment

Clinical sciences

Advanced Trainees will describe the principles of the foundational sciences.

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Eligibility considerations

Advanced Trainees will assess the patient’s current condition and plan the next steps.

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Less common or more complex patient considerations

Advanced Trainees will understand the resources that should be used to help manage patients.

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Undertaking therapy

Advanced Trainees will monitor the progress of patients during the therapy.

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Post therapy

Advanced Trainees will know how to monitor and manage patients post-therapy.

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management, and integrate these into care.

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Pharmacology and therapeutics of medications used in treatment
Pharmacology and toxicology of substances commonly consumed in Australia, excluding opioids
Pharmacology, treatment effect size, risks, benefits, and costs
Psychological approaches, including:
- cognitive-behavioural treatments
- contingency management
- mindfulness-based therapies
- motivational interviewing
- narrative and family-based treatments
- screening and brief interventions
- structured problem solving

Determination of risks associated with substance use in individual patients
Stepped-care approach
Stratification of response against severity and complexity
Substance dependence or substance use disorder, together with other relevant clinical diagnoses
Use of multiple substances and associated risks, particularly alcohol and sedatives

Complex presentations, such as:
- mixed intoxications
- withdrawals
Management of substance use disorders during acute hospital admissions
Multiple substance use disorders, and risks this may present
Pregnancy and substance use disorders
Substance use disorders in patients with:
- hepatic disease
- kidney disease
- respiratory disorders
- severe cardiac disorders
- sleep disorders
Treatment in patients with comorbid mental health disorders
Treatment in patients with impaired capacity / cognitive impairment

Collaborative treatment matching
Ensuring that treatment services are culturally safe for Aboriginal and Torres Strait Islander people and Māori
Monitoring treatment, including:
- functional improvements
- hospital presentations
- treatment outcome measures
- urine toxicology
Ongoing case management and multidisciplinary planning
Problem and goal definition, and care planning
Showing empathy and understanding, and demonstrating appropriate professional behaviour
Tailoring treatment in specific populations including groups, such as:
- homeless people
- the LBGTQIA+ community
- young people
Treatment fidelity

Long term trajectories of patients who have engaged in treatment
Optimising transitions between specialist services and primary care or custodial services, and government and non-government organisations
Planned treatment cessation
Unplanned treatment cessation

Awareness of medications prescribed for a range of psychological disorders, and advise accordingly where there is potential for misuse
Designing and operating services and service systems to meet the needs of Aboriginal and Torres Strait Islander people and Māori
Developing and operating services for diverse and/or underserviced populations
Ensuring health practitioners and hospitals have guidelines for ongoing management of patients with common substance use-related problems, including withdrawal management and acute stimulant presentations
Ensuring transitions are as smooth as possible between:
- colleagues in private practice
- custodial services
- government services
- non-government services
- primary care
- specialist services
High priority patients for treatment
Ongoing advocacy and actual supporting structures for identifying and addressing risky substance use in primary care, such as:
- advisory services
- screening
- other supports
- pathways
Roles of pharmacological approaches to substance use disorders (non-opioid), and synergies with psychological approaches