Dual Diagnosis: Best Practices for Treatment

Dual Diagnosis refers to clients who present with mental health and substance abuse issues. These individuals pose unique challenges for treatment providers, as research has shown that both issues need to be addressed concurrently in order for treatment to be effective. Unfortunately, many mental health providers do not have the training or expertise to deal with the complex issues of substance abuse, while many substance abuse facilities are not well-equipped to handle persons with severe psychiatric disorders. Furthermore, since one problem may mask symptoms of another, some individuals may only be diagnosed with either a mental health or substance abuse disorder, and thus only receive treatment in one area. This is a huge problem, since according to the Journal of the American Medical Association; approximately 50 percent of individuals with severe mental health problems also have struggles with substance abuse. For successful recovery to occur, professionals must be able to accurately diagnose problems in both areas, and then develop an integrated approach to treatment.

Effective treatment requires integration between mental health and substance abuse treatment providers, preferably in a single setting, so that both issues are treated concurrently. Clients should have integrated treatment plans that target the relationship between addiction and trauma, and mental health and relationship issues. Goals should be designed to help clients access and utilize supports in the community such as groups, school, and educational literature. Many clients will need medication to help them to recover and remain stable so that the desire to abuse substances is reduced. Therefore, the participation of medical providers in treatment is essential. Motivational interviewing is an evidenced-based practice that can help clients to explore the gaps between their goals and their current behavior, as well as some of the potential consequences of continuing to abuse substances. Finally, it is essential that providers include the client’s family in treatment as much as possible. A family’s knowledge of their loved one’s disorders and continued support after treatment is linked with more successful outcomes.

Greg Eaton, Gateway Foundation