A Shifting Understanding of Dual Diagnosis
Dual diagnosis treatment, while rising in popularity, still isn’t the standard for all mental health practitioners. Modern research is discovering how mental health conditions may lead to or worsen other illnesses; it’s clear we need to address every facet of emotional, mental, and physical distress.
The term “dual diagnosis” has been around since the 1980s; even then, conditions were treated separately or only one of the conditions received treatment. Even understanding that a person suffered two related conditions didn’t impact the kind of treatment they received. Unfortunately, research on the effectiveness of this kind of treatment is lacking because dual diagnosis clients don’t necessarily receive dual diagnosis treatment, which results in mixed results.
Despite the limitations of current research and differing terminology (co-occurring vs. dual diagnosis vs. comorbid), it is increasingly evident that success is more likely for clients who receive treatment for both conditions.
Limitations of Programs That Don’t Practice Dual Diagnosis
Substance abuse and mental illness, among many other co-occurring disorders, require careful, diligent treatment because the interaction of conditions makes them harder to treat. Treating only one condition will make a positive treatment outcome less likely. Substance abuse treatment centers that claim to not be equipped to deal with mental illness are doing a disservice to dual diagnosis clients.
Most practitioners agree that substance use is a coping mechanism, a form of self-medicating that does more harm than good. Treating the underlying mental illness that a person is self-medicating should have a positive treatment effect on the substance use disorder. However, even treating the underlying mental health condition without treating the substance use disorder isn’t sufficient to enact long-term change.
At some point, self-medicating becomes a compulsion with its own set of triggers and trauma, and using substances isn’t a purposeful action, it becomes a symptom in itself. While substance use disorders often originate in mental or physical illness, treating the original illness will allow the person to create healthy coping mechanisms, but treating the substance use disorder will help prevent a relapse.
Is Dual Diagnosis Hard to Implement?
The primary limitation providers face in implementing dual diagnosis treatment is finding specialized staff for the treatment of co-occurring disorders, especially severe ones. Because dual diagnosis clients are more at risk of severe social, familial, and health problems and suicide, treatment needs to be complex and adaptable to fit the needs of the client.
One consideration for the lack of dual diagnosis treatment options is that some of the common disorders that co-occur with substance use are difficult to treat even without a substance use component. According to current trends outlined in Closing the Gap: A Capability Framework for Working Effectively With People With Combined Mental Health and Substance Use Problems (Dual Diagnosis), dual diagnosis treatment would fall primarily on mental health providers before substance use experts if the client primarily exhibited symptoms of mental illness with less severe elements of substance use. As primary substance dependence is rarer than using substances to self-medicate, the primary burden of treatment falls on therapists.
As primary providers for dual diagnosis care, if therapists don’t treat some difficult co-occurring disorders such as schizophrenia and personality disorders, comprehensive treatment for those severe co-occurring disorders is limited.
To summarize, dual diagnosis needs to address complex needs for clients suffering multiple conditions. Oftentimes trained staff with expertise in those areas is limited, either due to the program’s budget or to the number of practitioners who treat difficult but common co-occurring disorders.
Despite all of these limitations, a primary therapist could implement dual diagnosis treatment practices into their regular treatment regimens.
5 Tips to Boost Your Regular Treatment With Dual Diagnosis Treatment Techniques
Substance use disorder has its triggers and emotional consequences. Treating these components in conjunction with your regular treatment can boost the effectiveness of your treatment for dual-diagnosis clients. To begin implementing dual diagnosis treatment, try these tips:
#1. Get your client’s family or close friends involved in their treatment. Constant support is a major component of substance use recovery that greatly increases the likelihood of success.
#2. If a client is presenting severe substance use issues, they may need sequential dual diagnosis treatment and should be referred to a substance use treatment center before progress can begin on their mental health condition.
#3. Involve your client in their treatment. Allow them to make decisions and direct the flow of their treatment by generating ideas, giving feedback, and making choices.
#4. Address triggers for their substance use habits and replaces them with holistic coping mechanisms. Clients who wake up and use cannabis to start the day may instead benefit from immediately meditating or doing yoga to overcome that morning compulsion.
#5. Establish a routine and accountability for good sleeping and eating habits. Control over a schedule and physical health will aid in control over substance use compulsions.
At Casa Recovery, trained staff with specialties in difficult to treat comorbid disorders enable us to offer the best in dual diagnosis treatment. Not only can we offer simultaneous dual diagnosis treatment, but our residential substance use recovery program allows for intensive substance use treatment that prepares clients for mental health disorder therapy in the next level of care at Casa Recovery. Dual diagnosis treatment is best achieved through collaborative care with a client’s primary therapist and treatment programs like Casa Recovery’s. While you can implement elements of dual diagnosis treatment in your regular sessions, you don’t have to carry the burden of your client’s recovery on your own. Our specialized, qualified staff are prepared to assist you in providing the highest quality of care for your clients, giving them the best chances of recovery. Call Casa Recovery at (888) 928-2272 to begin collaborating in dual diagnosis treatment for your clients.