A dual diagnosis of co-occurring behavioral health conditions has been described as having the worst of both worlds. The symptoms of both disorders can become comorbid and intertwine, causing relapse if both disorders are not fully treated at the same time. Unfortunately, in this nefarious chicken-or-the-egg scenario, conventional treatment is insufficient to address issues, leading clinicians to try alternative means.
The needs of dual diagnosis patients
A 2007 report prepared by the National Health Care for the Homeless Council notes, “Substance use often exacerbates cognitive impairment over the long term, making recovery and response to traditional addictions treatment more difficult.” The report focuses on meeting the needs of the homeless with dual diagnosis, but its findings are applicable to any individual with co-occurring conditions.
Under the section regarding effective treatment, the authors write, “Programs recognized for providing effective treatment to homeless people with substance use disorders consistently emphasize that a continuum of comprehensive services is needed to address their safety, health, social and material needs – including help obtaining food, clothing, stable housing, identification papers, financial assistance and entitlements, legal aid, medical and dental care, psychiatric care, counseling, job training, and employment services.”
That’s a tall order for any agency to fill. And it is entirely possible an individual with dual diagnosis who is not homeless does not require such assistance. But, as the Substance Abuse Mental Health Services Administration notes, “Co-occurring disorders can be difficult to diagnose due to the complexity of symptoms, as both may vary in severity. In many cases, people receive treatment for one disorder while the other disorder remains untreated. This may occur because both mental and substance use disorders can have biological, psychological, and social components.”
Tools for treatment
Cognitive behavioral therapy (CBT) is one evidence-backed modality for effectively treating dual diagnosis. instrumental in disabusing individuals of the negative opinions they have of themselves. Therapists challenge patients to create a new self-narrative; one that is nurturing, supportive. While CBT can be an effective treatment for someone with dual diagnosis, the challenge for the therapist is to work through the sometimes severe delusions these patients harbor.
SAMSHA recommends integrated treatment for individuals with a dual diagnosis. This treatment is based on evidence-based practices (EBPs). An evidence-based practice is defined as “the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care.” The Administration publishes a number of resources on developing and implementing EBP Knowledge Informing Transformation or “Kit.” On the EBP site, SAMSHA recommends the following resources for any therapist or practice interesting in building an effective EBP Kit:
Sovereign Health’s Rancho San Diego Adolescent Treatment Program combines CBT, experimental, group, individual and peer-to-peer therapy to treat co-occurring mental health issues and substance use disorders. Our substance abuse treatment program begins with the patient assessment. Our clinicians assess each patient for all outward and underlying conditions. Based on this assessment, they construct a treatment program tailored to meeting the patient’s individual needs. Call our 24/7 helpline for more information.
About the author:
Darren Fraser is a content writer for Sovereign Health. He worked two and half years as reporter and researcher for The Yomiuri Shimbun until they realized he did not read, speak or write Japanese and fired him. Undeterred, he channels his love of research into unearthing stories that provide hope to those dealing with addiction and mental illness. Darren loves the Montreal Canadiens hockey club and horror films and would prefer to enjoy these from the comforts of his family’s farm in Quebec. For more information about this media, contact the author at firstname.lastname@example.org