Presents a model for treating specific mental illnesses when combined with substance abuse, integrating theory, research, and techniques from the substance abuse and general mental health fields. Each mental disorder is presented with assessment procedures, prioritized treatment goals, and a detaile
This comprehensive clinical handbook provides virtually everything needed to plan, deliver, and evaluate effective treatment for persons with substance abuse problems and persistent mental illness. From authors at the forefront of the dual disorders field, the book is grounded in decades of influential research. Presented are clear guidelines for developing integrated treatment programs, performing state-of-the-art assessments, and implementing a wide range of individual, group, and family interventions. Also addressed are residential and other housing services, involuntary interventions, vocational rehabilitation, and psychopharmacology for dual disorders. Throughout, the emphasis is on workable ways to combine psychiatric and substance abuse services into a cohesive, unitary system of care. In a convenient large-size format, the volume includes reproducible assessment forms, treatment planning materials, and client handouts.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
This book includes a compilation of papers published in 2020 and 2021 focused on dual disorders, which are found in significant and growing numbers in both substance addiction and mental health clinics. These contributions assume a broad perspective ranging from exposure to genetic and neurobiological elements to factors such as personality and quality of life. In all cases, these papers aimed to be transferred to and to benefit clinical practice.
Co-occurring Mental Illness and Substance Use Disorders: A Guide to Diagnosis and Treatment provides a clinically detailed, evidence-based, and exhaustive examination of a topic rarely plumbed in psychiatry texts, despite the fact that co-occurring mental illness and substance use disorders are common. The authors argue for a more holistic and integrated approach, calling for clinicians to tactfully but persistently evaluate patients for a broad range of co-occurring disorders before determining appropriate treatment. Focusing on a substance use disorder in isolation, without determining whether another psychiatric disorder is co-occurring, can doom treatment efforts, and the reverse also is true. To help clinicians keep the big picture in mind, the book is organized around 18 cases, each of which addresses a particular diagnostic skill (e.g., assessment), group of disorders commonly comorbid with substance use disorders (e.g., PTSD, eating disorders), specific treatment (e.g., pharmacological interventions), or special population (e.g., adolescents). This case-based approach makes it easy for readers to understand strategies and master transferable techniques when dealing with their own patients. Because the initial face-to-face sessions are especially important with this patient population, the book includes chapters on the diagnostic assessment and the initial interview, as well as offering interviewing tips throughout to help the clinician develop the necessary care and skill in this arena. Also included is a chapter on integrating motivational interviewing into the treatment. Each of the 18 cases stands alone, allowing the reader flexibility in using the text. For example, the 18 cases and discussions can be read sequentially, or as needed, depending on the reader's special interest or current need. The book also features chapters on how to effectively work with patients whose disorders might be affecting other members of a patient's family, since the likelihood of a successful outcome is enhanced if an integrated treatment plan is developed for their co-occurring disorders. The questions that accompany each chapter can be used as an organizational tool prior to reading or to test knowledge and comprehension afterward. The text is completely up-to date and provides DSM-5 diagnostic information essential to each case. Co-occurring Mental Illness and Substance Use Disorders: A Guide to Diagnosis and Treatment offers a straightforward approach to people with complicated presentations, offering mental health clinicians the skills they require to effectively assess, diagnose, and treat these patients and their families.
Updated for today's health care climate, the revised and expanded second edition of this popular volume offers a thorough introduction to clinical work with this difficult-to-treat population. Providing a unique synthesis of chemical dependency and mental health models, the book articulates a framework for assessment and treatment and describes a range of effective counseling and motivational strategies for adolescents and adults. The second edition includes discussions of the latest developments in treatment, sample treatment plans, increased coverage of ways to incorporate 12-step concepts into mental health interventions, and a new section on trauma-based disorders in addicted female adolescents. The practical utility of the volume is enhanced by clinical vignettes, clearly presented tables, and reproducible forms.
Co-occurring Substance Abuse and Mental Disorder: A Practitioner's Guide is a basic overview of current evidence-based practices for treating co-occurring disorders. Co-occurring disorders, also known as dual diagnosis, refers to individuals who have both a mental illness and a co-morbid substance use disorder. The literature suggests that utilizing an "integrated" approach to treatment, treating both disorders concurrently in a program with clinicians specially trained in mental illness and substance abuse, provides the best outcomes for this population. This book is designed to provide clinicians with the basic knowledge and skills required to effectively assess and treat co-occurring disorders.
Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
This handbook addresses behavior problems and mental health disorders in persons with intellectual disabilities. It provides an overview of the history of dual diagnosis and related theories, ethics, diagnostic systems, mental health disorders, and challenging behaviors. The handbook examines general clinical issues, such as the effects of cognitive performance on the choice of assessment and treatment methods, service delivery systems, education models, risk factors, functional assessment, and structured interviews. Chapters provide a much-needed reference for practitioners and practitioners in training. The applied focus of the book continues with assessment/diagnosis sections of mental health disorders, and challenging behaviors. In addition, chapters describe treatments for discrete mental health and behavior problems, such as intellectual disabilities, severe psychopathology, autism, ADHD, substance abuse, and aggression. Topics featured in this handbook include: Genetic disorders and dual diagnosis. Assessment of anxiety in persons with dual diagnosis. Aging with intellectual disabilities. Feeding problems and assessment in individuals with dual diagnosis. Pica in individuals with intellectual disability. Treatment of social skills in dual diagnosis. The Handbook of Dual Diagnosis is an essential reference for researchers, graduate students, clinicians and related therapists and professionals in clinical child and school psychology, child and adolescent psychiatry, social work, developmental psychology, behavioral therapy/rehabilitation, pediatrics, and special education.