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What are effective approaches to treating a young adult with co-occurring mental health and substance use conditions? What are the key factors that make these approaches effective? Where can I go to find more information and materials on the most effective approaches in treating co-occurring mental health and substance use conditions?
What are effective approaches to treating a young adult with co-occurring mental health and substance use conditions? What are the key factors that make these approaches effective? Where can I go to find more information and materials on the most effective approaches in treating co-occurring mental health and substance use conditions?
Last updated by SofU Admin
The effective approach to helping anyone of any age who has co-occurring conditions is what is generically called “integrated treatment,” where clients engage in a relationship with an individual, a team, a program or a community of recovering peers and clinicians, and in the context of that relationship they work on addressing each of their issues, step-by-step over time, in order to achieve their recovery goals of a happy life.
The Integrated Dual Disorder Treatment (IDDT) Toolkit is an evidence-based toolkit specifically designed for adults, including young adults, with serious mental health conditions and substance use issues. Although some systems have special IDDT teams or programs, these “tools” can and should be applied to any type of program. In many county and state systems, all programs are working on becoming recovery oriented and co-occurring capable, so that people with co-occurring issues can get help anywhere.
Key elements of successful co-occurring conditions care include these basic principles:
- Individuals with co-occurring conditions should be welcomed, including when they are actively using, and inspired with hope that they will get help to address all their issues to have a happy life. There should be welcoming “screening” so that it is easy for the client to share all of his or her issues, and have them documented and addressed.
- Relationships should be empathic, hopeful, integrated and strength based and address all problems as primary.
- Substance use issues, like other conditions, do not get “fixed,” so much as people are helped to build on their existing strengths and hopes to make step-by-step progress over time for all their issues in a process that is adequately supported, adequately rewarded (rounds of applause for small steps or progress), strength based (build on existing successes), skill based (learning how to make progress very concretely one day at a time), stage matched (matching progress to stage of change or stage of treatment) and community-based learning.
In general, like for other conditions, people make progress slowly. The research will show that for young adults first entering treatment with co-occurring conditions, who are not initially interested in changing their substance use, a good integrated treatment approach will take three to four years for half the young adults to be stably sober, while most of the rest are making significant progress even though they may still be using. However, if you get engaged in a good integrated partnership, you can make important progress in six to twelve months, in terms of reducing use, getting in less trouble and have fewer crises.
There are many references and resources available on this topic. You can obtain manuals designed for clients with co-occurring illness from organizations like:
- Hazelden (www.hazelden.org);
- Foundations Associates (www.dualdiagnosis.org); and
- Self-help organizations like Dual Recovery Anonymous, Dual Recovery Resources, Dual Diagnosis Anonymous and Double Trouble in Recovery.
In addition, you may want to read materials that are provided for entry level professionals, including:
- The Northeast Addiction Technology Transfer Center (www.neattc.org) has training materials for adults and adolescents with co-occurring conditions.
- Dr. Kim Mueser at Dartmouth has co-authored a textbook for front line case managers titled, Integrated Treatment for Dual disorders: A Guide to Effective Practice.
- I have resources on my own Web site at www.kenminkoff.com and my company’s Web site at www.ziapartners.com. Additionally, ZiaPartners has a FaceBook group for consumers and clinicians who want to improve integrated services called the Change Agent Connection.
- SAMHSA has a co-occurring disorder resource information Web site available at http://coce.samhsa.gov/.
- The Ohio SAMI Coordinating Center of Excellence also has a co-occurring disorder resource Web site at www.ohiosamiccoe.case.edu.