Three Treatment Options for Dual Diagnosis

Co-occurring disorders, or dual diagnoses, refers to cases involving substance use disorder (SUD) and another mental health condition being coexisting and worsening each other’s effects on an individual. Researchers agree that although causal relationships cannot always be pinpointed between them, often times both can worsen each other’s effects over time.

The National Institute on Drug Abuse estimates that eight million American adults have dual diagnoses. More cases appear to involve people diagnosed with SUD also suffering from mental health conditions than vice versa; regardless, over half of these cases receive no treatment for both conditions (1)

Treating a dual diagnosis requires treating both substance use disorder (SUD) and mental health condition, regardless of which caused which. Although this can be challenging for specialists at treatment facilities like and similar facilities, treating dual diagnoses is far from impossible – here are three treatment strategies available to manage such cases:

Most treatment programs for substance use disorder and mental health conditions tend to operate independently from each other, allowing patients to undergo treatments for both issues simultaneously with its respective set of specialists. Unfortunately, this approach may create unnecessary gaps in care between treatments that reduce effectiveness in the long run (2)

Researchers have devised an Integrated Dual Diagnosis Treatment (IDDT). By having a team of specialists provide simultaneous care, this model may reduce factors like:

Probability and Cost of Relapsing for SUD or Mental Health Conditions [CORESUD], Patient Services Shouldered By Individual (PAI), Need for Extended Hospitalization or Arrest and Overhead expenses on Facility’s Part (OHCs).
IDDT becomes even more appealing when considering that traditional treatment methods still involve substances. For instance, treating schizophrenia involves antipsychotic medications like Clozapine, Olanzapine, Risperidone, and Quetiapine in addition to nonpharmacological procedures; CBT should complement these drugs (2)

Randomized trials have demonstrated the efficacy of integrated treatment on patients. One such research study with schizophrenia and dual diagnosis patients found that those undergoing integrated therapy experienced significant improvements to their quality of life one year later – not to mention a lower dropout rate! (2)

Integration of Cognitive Behavioral Therapy (CBT) with Motivational Interviewing

Practitioners and patients alike are familiar with cognitive behavioural therapy (CBT); it is one of the most widely employed strategies for treating mental health conditions. CBT’s widespread usage stems from its ample research base as well as being considered the “gold standard” available at present.

But “gold standard” doesn’t imply perfection – and CBT in mental health is no different – constantly evolving alongside cutting-edge treatment models that work alongside it rather than replace it.

One such treatment combining CBT with motivational interviewing is dual diagnosis treatment: CBT combined with motivational interviewing. According to William Miller, Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico, motivational interviewing’s purpose is to assist people in making changes through various communication techniques (4)

Motivational interviewing can be used in a wide variety of cases, yet its true potential shines when used with patients who present specific conditions like:

Mixed reactions about changing for the better
Some are uncertain if their changes can bring positive outcomes and few want to disrupt their status quos.
CBT and motivational interviewing combine well as complementary approaches for treating substance use disorder and depression in youths; one study conducted using these combined approaches reported decreased cannabis prevalence three and six months post-treatment (2)

Simultaneous Treatment Approaches

If integrated treatment isn’t feasible, practitioners can still arrange parallel therapy as an alternative approach. While integrated care involves one team providing care, parallel treatment involves various providers or systems giving care.

Contrary to popular belief, parallel treatment offers concurrent care similar to integrated treatments. One setup may allow patients to undergo medication at their treatment center while also being referred to a support group for intervention within the same timeline. According to experts, parallel treatments work for those suffering from two disorders with severe manifestations and two mild ones respectively.

Final Thoughts

Dual diagnosis is more prevalent than many may realize, with its complex nature–suffering from two conditions without knowing their underlying source–requiring effective treatment methods to combat both of them. No matter the case may be, remembering help is always available somewhere is always beneficial.







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