Our outpatient IOP for addictions is hoping to include some clients with co-occurring disorders. How do we make the transition to serve this population?”

SAMHSA has published extensively on the subject of co-occurring disorders (COD) and has resources you should definitely take advantage of. Their helpful site offers free tools.

Check out their TIP 42 (Substance Abuse Treatment for Persons with Co-Occurring Disorders) and TIP 48 (Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery) – both free and good introductory material on the subject. Don’t stop there; there’s plenty of other good material available.

To me, the key question involves which part of the COD population you’re going to serve. It’s not really a homogeneous group. The treatment of someone who suffers from chronic schizophrenia is different from treatment of, say, a moderately depressed alcoholic.

Once you’ve decided who you should focus on, you can follow these broad steps:

  • Develop a patient education program for CODs, with materials and workbook. Use something evidence-based, but expect to have to adapt it to your program.
  • Train your staff to use an integrated treatment plan that gives co-equal status to both disorders. You can get some outside help in this respect, too.
  • Do additional training to make your staff not only more skilled but also more confident in their abilities with COD clients.
  • Develop links with mental health services that your clients will need but you don’t provide. Set up referral procedures and agreements for exchange of confidential info with these agencies.
  • Develop policies and procedures for the above and distribute them to all employees.
  • Incorporate aspects of service for COD clients into your CQI or PE program, so you can monitor your agency’s progress.