Treatment of Persons with Co-Occurring Disorders
Based on SAMHSA TIP 42 Parts 1&2
Host: Dr. Dawn-Elise Snipes
Executive Director: AllCEUs Counselor Education
Podcast Host: Counselor Toolbox and Addiction Counselor Exam Review
Objectives
~ Define Co-Occurring Disorders
~ Review the relevance of co-occurring disorders research to clinical practice
~ Familiarize with the following terms: Substance Use Disorders, Mental Disorders, Compulsive Behaviors/Behavioral Addictions, Treatment Programs, Systems
~ Co-Occurring Disorders means that the person has a substance use or addictive disorders AND a concurrent mental health issue that is not attributable to the effects of intoxication or withdrawal
~ What challenges do clients with co-d present in treatment settings? To clinicians?
~ Co-Occurring Disorders
~ Create multiple treatment issues
~ Impact treatment due to varying course of both disorders
~ Models and strategies for addressing co-d
Prevalence
~ An estimated 10 million Americans have COD in any given year
~ Using only DSM criteria
~ Not including nicotine addiction or eating disorders
~ COD are the expectation, not the exception
~ People with COD are more likely to be hospitalized
~ Rates of mental health issues increase as the rate or substance use disorders increases
Principles of COD Treatment
~ No Wrong Door
~ Mutual Self-Help
~ Integrated care
~ Individualized approaches including
~ Psychotherapy
~ Medication Assisted Therapy
~ Peer Support
~ Community Based Resources
Mood Disorders
~ Anxiety
~ Social
~ Generalized
~ Depression
~ Persistent Depressive Disorder
~ Major Depression
~ Bipolar Disorder
~ Mania or Hypomania plus Depression or PDD
Other Non-Personality Disorders
~ ADD/ADHD
~ Autism Spectrum Disorders
~ PTSD
~ Schizophrenia
~ Alcohol Induced Dementia (Wernicke-Korsakoff’s Syndrome)
~ Obsessive Compulsive Disorder
~ Issues w/Dementia
~ Age-Related Dementia
~ Alzheimer’s Disease
~ Parkinson’s Disease
Personality Disorders
~ Cluster A
~ Odd or Eccentric Behavior
~ Paranoid, schizoid, schizotypal
~ Cluster B
~ Dramatic, Emotional or Erratic Behavior
~ Antisocial, borderline, histrionic, narcissistic
~ Cluster C
~ Anxious, fearful behavior
~ Avoidant, dependent, obsessive-compulsive
Addictive Disorders
~ In the DSM V
~ Substances
~ Gambling
~ Internet Gaming Disorder (of interest)
~ NOT in the DSM
~ Sex addiction
~ Pornography addiction
~ Shopping addiction
~ Eating disorders and food related issues are not considered addictions
Criteria for Addiction
~ Use for longer than intended
~ Spending more money than intended
~ Failed efforts to quit or cut down
~ Giving up important activities
~ Development of a tolerance
~ Physiological or psychological withdrawal
~ Negative consequences in one or more areas of life related to the addiction
ASAM Levels of Care
Quadrants of Care
Recovery Oriented System of Care
~ Comprehensive Continuous Integrated System of Care
~ What types of services would be needed here?
~ Substance Use
~ Mental Health
~ Medical
~ Pain Management
~ Parenting
~ Financial
~ Occupational/Educational
~ Case management
Summary
~ Co-Occurring Disorders Treatment means providing concurrent services to meet the mental health as well as addiction needs of individuals
~ Co-Occurring Disorders treatment recognizes the reciprocal impact of each disorder on the other
~ Overlooking the MH or SAB in diagnosis or treatment sets a person up for relapse
~ COD Treatment is integrated and attends to the whole person
~ Clinicians have an ethical responsibility to be educated in both MH as well as SAB issues and treatments even if they are not “skilled” in treating one or the other.
More Videos
~ There are 5 more videos in this series. They will all be on the playlist “TIP 42 Co-Occurring Disorders” on our YouTube channel AllCEUs.com/YouTube
~ To earn CEUs for this presentation, go to AllCEUs.com/podcastCEUs where you can find a direct link to the class associated with this presentation