Pair of shoes standing on a road with arrowOur 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 new site launched in Spring 2011.

Also 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.


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