Substance Abuse treatment series address the importance of step down services in preventing relapse among persons with co-occurring disorders.
Models of Treatment for Co-Occurring Disorders
Dr. Dawn-Elise Snipes PhD, LMHC, CRC, NCC
Executive Director, AllCEUs.com
Lerner Objectives
Identify the most common settings for co-occurring disorders treatment
Differentiate between the levels of treatment from intervention to residential level IV.
Identify specific characteristics of treatment in problem solving courts, jails
Settings
Health Departments and Social Services
Behavioral Healthcare Centers
Private Practice Offices
Hospitals
Schools
Jails
Prevention
Averting problems before they begin through modifying risk and protective factors in the following domains:
Individual
Family
School
Community
Examples
Educating children about drugs and their effects
Improving communication among families
Ensuring children are able to engage in school
Improving community stability, organization and attachment.
Intervention
Providing resources to prevent worsening of addiction or other biopsychosocial issues that could lead to addiction.
Methods
Psychoeducational groups and classes
Early identification of persons with risk factors for mental health, stress related or substance abuse issues
Frequency: Once per week
Setting:
School
Church
Community Center
Clinic
Home
Online/phone
Outpatient
Individual and group counseling sessions
Frequency: 1 to 3 times per week
Setting:
Clinic
School
Online/Telephone
Home
Issues
Coping skills
Maladaptive emotions/reactions; thoughts and/or behaviors
Relationship and interpersonal issues
Past traumas and losses
Intensive Outpatient
Individual and group counseling sessions
Frequency: 3 to 5 times per week for a minimum of 3 hours per day
Setting:
Clinic
Online
Issues
Coping skills
Maladaptive emotions/reactions; thoughts and/or behaviors
Relationship and interpersonal issues
Past traumas and losses
Partial Hospitalization
Individual and group counseling sessions
Frequency: Daily
Setting: Clinic (Patient sleeps off campus)
Issues
Coping skills
Maladaptive emotions/reactions; thoughts and/or behaviors
Relationship and interpersonal issues
Past traumas and losses
Short-Term Residential
Individual and group counseling sessions
Frequency: Daily for up to 60 days
Setting: Clinic (Patient sleeps on campus)
Issues
Coping skills
Maladaptive emotions/reactions; thoughts and/or behaviors
Relationship and interpersonal issues
Past traumas and losses
Long Term Residential
Individual and group counseling sessions
Frequency: Daily for up to 1 year
Setting: Clinic (Patient sleeps on campus)
Issues
Coping skills
Maladaptive emotions/reactions; thoughts and/or behaviors
Relationship and interpersonal issues
Past traumas and losses
Medication management
Establishment of wrap around services
Criminal Justice
Individual and group counseling sessions
Frequency: Daily
Setting
Jail
Intensive outpatient as with problem solving courts
Issues
Coping skills
Maladaptive emotions/reactions; thoughts and/or behaviors
Relationship and interpersonal issues
Past traumas and losses
Changing criminogenic thinking
Reintegration services
Case Management and linkages with wrap around services
Job and life skills
Problem Solving Courts
Created to assist consumers whose illegal behaviors are thought to be a result of an underlying substance abuse or mental health issue.
Involve
Weekly monitoring by the court
Daily contact with a counselor
Provision of sanctions based on noncompliance
Progression through phases based on demonstrated improvements in behaviors, reactions and relationships
Summary
Consumers should be placed in the least restrictive environment
There are benefits and drawbacks to all levels of care
Outpatient
Intensive outpatient
Short term residential
Long term residential
Problem solving courts have demonstrated much success
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