With so many different models, behavior intervention requires a multi-component program and integrated addiction treatment plan that generates a problem list and creates interventions to respond to each problem on the list. This necessitates a multi-disciplinary team to assess and deliver treatment to fit the patient’s tolerance and abilities.
Providing specific recommendations for screening patients with substance abuse disorders and psychiatric disorders
Assessing the individual’s motivation to change
Managing any medical conditions that co-occur with dual diagnoses patients (such as liver complications, lung cancer, cardiovascular disease, HIV, and hepatitis B or C infections) and selecting appropriate medications to manage those medical conditions
Psychosocial interventions for dual-diagnosed patients (dual recovery therapy, modified cognitive behavioral therapy, modified motivational enhancement therapy, management of substance abuse model, and others, as appropriate).
Pharmacotherapy for treating psychiatric disorders and co-occurring substance abuse, as well as depression, anxiety, and sleep problems.
Data from numerous studies have shown that second-generation antipsychotics (aripiprazole, clozapine, olanzapine, quetiapine, and risperidone) may be superior to conventional antidepressants in treating individuals with schizophrenia and co-occurring substance abuse. Substance abuse disorder is the most common co-morbid psychiatric disorder in patients with schizophrenia.
Medications such as these, or others, maybe suggested for the treatment of psychiatric disorders and substance abuse. For co-occurring schizophrenia and substance abuse, however, administration of second-generation antipsychotics, coupled with anti-craving medications and tricyclic antidepressants, may be recommended.
Integrated treatment helps not only the dual disorder patients but also their families, friends, and others. Evidence shows the effectiveness of integrated treatment. Individuals with a substance abuse disorder are more likely to receive treatment if they have a co-occurring mental disorder. According to research, when individuals with dual diagnosis overcome alcohol abuse, their response to treatment rapidly improves.
For effective integrated treatment, The first requirement is to establish trust between the client and the caregiver. Trust is important to motivate the individual to learn the skills to control their illnesses and to focus on goals. Keeping the client on track helps to prevent relapse. Individualized treatment can begin at any of these stages.
Effective assertive outreach programs, using intensive case management, engage and retain clients at a high rate. Such outreach includes meeting at the client’s residence, developing a dependable relationship, and ensuring that the client is consistently monitored and counseled.
Effective treatment also requires motivational interventions, including counseling, support, and education. This helps clients who are deeply demoralized to better be able to recognize how important it is for them to develop goals and to self-manage their illnesses.
Fundamental to any treatment of dual diagnosis, counseling helps clients develop positive coping patterns, as well as learn cognitive and behavioral skills. Individual, group, family therapy, or a combination of all of these is recommended.
Persons with a dual diagnosis need help to strengthen positive relationships and get rid of any that encourage negative or self-destructive behavior. The clients’ immediate environment has a direct effect on their moods and subsequent choices.
Treatment for the substance abuse and mental disorder client also must be comprehensive, taking into account various aspects of the client’s life: stress management, jobs, housing, activities, and social networks. The treatment considers both disorders (substance abuse and mental illness) as intertwined, not separate. Solutions to both are provided at the same time.
Integrated treatment programs can also benefit from being sensitive to the needs and competent in treating clients with services tailored to their particular cultural and racial needs.